Pesticide poisoning has been considered a major risk associated with the safety of farmers throughout the world, thus the health of farmers needs to be continuously assessed particularly with reference to pesticide exposure, to ensure occupational safety in agriculture. In the context of the aging farmer population and indiscriminate use of pesticides in developing economies such as Trinidad and Tobago, maintaining good health among farmers is highly essential to ensure food security and to reduce the country’s food import bill. In this regard, the current study was undertaken to assess the extent of pesticide poisoning and the prevalence of acute pesticide poisoning among farmers. The possible factors associated with this situation, such as frequency of pesticide use, use of personal protective equipment, knowledge, attitude, risk-perception and farming behaviours were investigated. A structured questionnaire was administered to a sample of 150 farmers in Central Trinidad. Results showed that 34% of farmers experienced at least one symptom of poisoning after pesticide use and 14% were found to have experienced acute occupational pesticide poisoning. The majority of farmers with acute pesticide poisoning reported: having received little training about pesticides; having used pesticides for at least 5 years having sprayed at least once per week; having a fair knowledge of pesticides; having overall a good attitude towards the use of pesticides; and having fairly good perception of associated risks. A formal monitoring system to track farmers’ health, training for both farmers and extension service providers and updating of pesticides regulations are the key recommendations of this study.