A case of organophosphorous poisoning in a 29 year old male who developed intermediate syndrome manifested by features of respiratory depression as evidenced by marked weakness of the respiratory muscles, tachypnoea, and drop in oxygen saturation despite reversal of nicotinic and muscarinic effects of organophosphorous poisoning. The case highlights its early recognition and prompt institution of mechanical ventilation with continuation of anticholinergic drugs. The mechanical ventilation had to be continued for 9 days with successful outcome.