Background: The incidence of Aluminum Phosphide (AlP) poisoning constituted one of the most common causes of poisoning death in low- and middle-income countries (LMICs). Aims: to evaluate the data available on the safety and efficacy of oil-based gastric lavage (GL) compared with standard therapy for the treatment of AlP poisoning. Design: were previously established (PROSPERO ID: CRD42022296780); an exhaustive search was carried out in different databases, identifying randomized controlled trials (RCTs). Settings: health centers of any level. Participants: Any person presented within 6 hours post-exposure to AlP. Interventions: Lavage solution with oils, including liquid paraffin or coconut oil. Findings: We identified 7 RCTs. The evidence from 4 RCTs indicates that GL with paraffin oil is an effective treatment for acute AlP poisoning, decreasing the mortality rate (RR = 0.62; 95%CI = 0.48 to 0.81; participants = 226; I2=10%; low-quality evidence). We estimate an NNT of 4. Likewise, this intervention reduces the need for intubation and mechanical ventilation (RR = 0.62; 95%CI = 0.40 to 0.79; participants= 226; I2 = 0%; low-quality evidence). Regarding GL with coconut oil, the evidence from 4 RCTs, indicates a slight reduction in mortality in patients with acute AlP poisoning (RR= 0.82; 95%CI = 0.69 to 0.98; participants= 112; I 2= 0%; very low-quality evidence). Conclusions: Limited evidence suggests that GL with paraffin oil is effective in reducing the mortality rate in acute AlP poisoning. Likewise, limited evidence showed in favor of paraffin oil concerning the need for intubation and mechanical ventilation. This efficacy was not confirmed in terms of length of hospital stay or the total amount of vasoactive agents used. Very limited evidence suggests that GL with coconut oil may have benefits in terms of mortality in patients with acute AlP poisoning. Very limited evidence suggests that both interventions would have a benign safety profile. Conclusions: Limited evidence suggests that GL with paraffin oil is effective in reducing the mortality rate in acute AlP poisoning. Likewise, limited evidence showed in favor of paraffin oil concerning the need for intubation and mechanical ventilation. This efficacy was not confirmed in terms of length of hospital stay or the total amount of vasoactive agents used. Very limited evidence suggests that GL with coconut oil may have benefits in terms of mortality in patients with acute AlP poisoning. Very limited evidence suggests that both interventions would have a benign safety profile.