tramadol as centrally acting analgesic is extensively used in the management moderate severe pain slightly affects receptors inhibits reuptake norepineprin serotonin reports toxicity abuse objective present study was evaluate epidemiology intentional all poisoning cases that admitted to loghman hakim hospital poison center form april to may 2007 were studied A total of 114 cases intentional tramadol intoxication with the median age range 16-54 years were identified other illicit drugs were found to be used in combination with tramadol in some of the cases which among them benzodiazepines were the most common . tramadol overdose has been one the most frequent causes of drug poisoning in the country in the recent years , especially in male young adults with history of substance abuse and mental disorders. nausea, vomiting ,central nervous system depression, tachycardia and seizure are the most commun findings in this kind of poisoning . cardiopulmonary arrest was found as the cause of death in cases who had ingested more than 5000 mg