Paper investigates the determinants of pesticide related Cost of Illness (COI), and acute symptoms, using a balanced panel of 363 farmers interviewed in 2005 and 2008. Finding shows that the incidences of pesticide-related health impairments have increased. Variation in number of symptoms and symptom severity significantly explained COI. The Personal Protective Equipment (PPE), education level, record keeping and geographical location considerably determined health impairments. Encouraging the proper use of PPE and record keeping of pesticide use could great reduce poisoning cases and COI.