This systematic review estimates the global burden of pesticide self-poisoning, which accounts for approximately one-third of all suicides worldwide. The study uses data from Medline, EMBASE, and psycINFO, as well as internet searches and personal collections, to estimate the number of pesticide suicides in each of the World Health Organization's six regions. The authors conservatively estimate that there are 258,234 pesticide suicides globally each year, with a plausible range of 233,997 to 325,907. Official data from India may underestimate the incidence of suicides, and applying evidence-based corrections to Indian data increases the global estimate to 371,594 (347,357 to 439,267). The proportion of suicides due to pesticide self-poisoning varies from 4% in Europe to over 50% in the Western Pacific Region, influenced more by the pattern of pesticide use and toxicity than by the volume of sales. The study concludes that many of these deaths could be prevented by restricting access to highly toxic pesticides, improving safe storage practices, and enhancing the quality and accessibility of healthcare for poisoning.This systematic review estimates the global burden of pesticide self-poisoning, which accounts for approximately one-third of all suicides worldwide. The study uses data from Medline, EMBASE, and psycINFO, as well as internet searches and personal collections, to estimate the number of pesticide suicides in each of the World Health Organization's six regions. The authors conservatively estimate that there are 258,234 pesticide suicides globally each year, with a plausible range of 233,997 to 325,907. Official data from India may underestimate the incidence of suicides, and applying evidence-based corrections to Indian data increases the global estimate to 371,594 (347,357 to 439,267). The proportion of suicides due to pesticide self-poisoning varies from 4% in Europe to over 50% in the Western Pacific Region, influenced more by the pattern of pesticide use and toxicity than by the volume of sales. The study concludes that many of these deaths could be prevented by restricting access to highly toxic pesticides, improving safe storage practices, and enhancing the quality and accessibility of healthcare for poisoning.