目的了解杭州市重大职业性急性中毒事故发生的原因及其救援情况，进一步提高对重大事故的防范和管理。方法收集杭州市１３年间发生的２５起重大职业性急性中毒事故的劳动卫生调查资料，对事故发生的行业、企业、毒物品种采用流行病学分析方法进行统计分析。结果２５起事故共发生中毒１３１人，死亡２２人，乡镇企业的发生率超过国有企业；引起中毒的毒物共１０种，发病人数在前５位的毒物依次为硫化氢、苯、一氧化碳、光气和有机磷农药；１３１名中毒人员中因救援中毒４０人，死亡８人，救援人员中毒和死亡率高于直接作业工人。结论发生事故的原因以缺乏防护知识最为突出。本研究结果为建立基层应急救援体系提供参考依据。 Objective To understand the causes of major occupational acute poisoning accidents in Hangzhou and their rescue measures so as to further improve the prevention and management of major accidents. Methods The data of occupational health survey on 25 major occupational acute poisoning accidents occurred in Hangzhou during the past 13 years were collected and the epidemiological analysis methods were used to make statistical analysis on the industries, enterprises and poisons that occurred in the accident. Results Twenty-five accidents resulted in 131 poisonings and 22 deaths. The incidence rate of township and village enterprises exceeded that of state-owned enterprises. Ten kinds of poisoning poisonings occurred. The top five poisonings were as follows: hydrogen sulfide, benzene, carbon monoxide, phosgene And organophosphorus pesticides; among the 131 poisoned persons, 40 were poisoned due to rescue and 8 were killed. The poisoning and mortality of rescue workers were higher than those of direct workers. Conclusions The reason for the accident is the most prominent due to the lack of protective knowledge. The results of this study provide a reference for establishing a grassroots emergency rescue system.