Objective To explore the efficacy of atropine combined with naloxone in the treatment of patients with respiratory failure caused by organophosphate poisoning and its effects on renal function and serological markers. Methods 80 patients with respiratory failure caused by organophosphate poisoning who were admitted to the hospital from February 2015 to February 2018 were selected and divided into observation group and control group according to the random number table method, with 40 cases in each group. The two groups were given conventional treatment of respiratory failure caused by organophosphate poisoning, and control group was given atropine conventional treatment, and observation group was given atropine combined with naloxone, and the two groups were continuously treated for 7d. The renal function, serological markers and efficacy were compared between the two groups before and after treatment. Results After treatment, the atropinization time and hospital stay in observation group were shorter than those in control group (P<0.05), and the atropinization dosage, urine protein quantitation, urea nitrogen, creatinine, D-Dimer, BNP and mortality rate in observation group were significantly lower than those in control group (P<0.05), and the FT3 level and cure rate in observation group were significantly higher than those in control group (P<0.05). Conclusion Atropine combined with naloxone has significant efficacy in the treatment of respiratory failure caused by organophosphate poisoning, and it has effects of lowering serological markers and protecting renal function.