BACKGROUND Paraquat (PQ) is a non-selective and fast-acting contact herbicide which has been widely used in developing countries. Hyperamylasemia was reported in patients with PQ poisoning. This study investigated the predictive value and clinical characteristics of hyperamylasemia in patients with PQ poisoning. MATERIAL AND METHODS This study included 87 patients with acute PQ poisoning admitted from July 2012 to May 2015. Data were collected from medical records. Receiver operating characteristic (ROC) analysis was conducted to analyze the discriminatory potential of serum amylase with respect to 90-day mortality. RESULTS Of 87 patients, 29 patients had elevated serum amylase. We found that serum amylase was significantly higher among patients with AKI than those with non-AKI (p<0.001), and was an independent predictor of mortality (hazard ratio [HR]=3.644; 95% [CI], 1.684-7.881; p=0.001). The area under the ROC curve for the serum amylase (area under curve [AUC]=0.796; 95% [CI], 0.690-0.903) had a better discriminatory potential than plasma PQ concentration (0.698;0.570-0.825) or urinary PQ concentration (0.647;0.514-0.781) in predicting 90-day mortality. CONCLUSIONS Hyperamylasemia is a valuable early predictor of 90-day mortality in PQ poisoning.