Objective: The purpose of this study was to identify prognostic factors related to outcomes of out-of-hospital cardiac arrest caused by pesticide poisoning. Methods: This retrospective observational study used countrywide population-based data from the Out-of-Hospital Cardiac Arrest Surveillance of the Korean Centers for Disease Control and Prevention from January 2008 to December 2018. Adult out-of-hospital cardiac arrest (OHCA) patients (over the age of 18) poisoned by a pesticide who experienced cardiac arrest and a subsequent return of spontaneous circulation (ROSC) were included in the study. The primary outcome variables were prognostic factors related to survival at hospital discharge, and the secondary outcome variable was good neurological outcome (Cerebral Performance Categories 1 or 2) at hospital discharge. Results: Three hundred and three patients were enrolled in the study, and 48 (15.8%) survived until hospital discharge (the hospital discharge group), and 255 (84.2%) died in hospital (the in-hospital death group). Fifteen (4.9%) of the 303 study subjects had a good neurological outcome, and 288 (95.1%) had a poor neurological outcome. Multivariate logistic regression showed that sustained pre-hospital ROSC was significantly associated with survival to discharge (adjusted odds ratio [AOR]=3.186; 95% confidence interval [CI], 1.436-7.068; P=0.004) and good neurological outcome (AOR=8.945; 95% CI, 2.974-26.907; P≤0.001). Conclusion Sustained pre-hospital ROSC is associated with a favorable outcome in cases of OHCA induced by pesticide poisoning.