Background <p>Acute poisoning is a medical emergency that can be caused by exposure to significant levels of any chemical and has toxic consequences that typically manifest within hours of exposure, leading to significant morbidity and mortality.</p> Objectives <p>This study aims to determine the pooled prevalence and determinant of poor treatment outcomes of poisoning in Ethiopia.</p> Methods <p>The searches were conducted in electronic databases such as PubMed, MEDLINE, EMBASE, Science Direct, Web of Science, and Google Scholar. Original studies were selected and published until the end of December 2024, addressing the prevalence and determinant of poor treatment outcomes (death and disability) among patients. Endnote X-8 reference manager software was used to collect and organize the search outcomes and remove duplicate articles. Important data were extracted from the included studies using a format prepared in Microsoft Excel and exported to STATA 17.0 software for outcome measure analyses. The Higgins I² test statistics were used to examine heterogeneity, and a random-effects model was used to analyze the pooled prevalence and determinant of poor treatment outcomes.</p> Result <p>Eleven research articles and 10,089 poisoned patients were included in the final analysis. This study finding showed that the pooled prevalence of poor treatment outcomes among poisoned patients was 16.13% (95% CI: 9.20, 23.05). This meta-analysis study revealed that patients living in rural areas (AOR: 2.79, 95% CI: 1.44, 5.42) and delayed time to arrival (AOR = 6.15, 95%CI: 2.46, 15.34) were determinant factors of poor treatment outcome for poisoned patients in hospitals.</p> Conclusion and recommendation <p>This study findings stated that the pooled prevalence of poor treatment outcomes among patients was high. Patients living in rural areas and delayed time to arrival at health facilities were independent determinants of poor treatment outcomes.</p>