Abstract --Nerve agents are one of the most lethal chemical materials. They may be used as weapons of mass destruction in terrorist attacks or in the battlefield. Successful management is composed of many close organized steps. Early detection, field triage, decontamination, primary survey, resuscitation, and early antidote use are imperative in the acute stage of poisoning. Basic pharmacological therapy includes antidote (atropine and pralidoxime) and anticonvulsant therapy. We review the basic physical properties, the pathophysiology, and the acute management of nerve agents poisoning.