The United Arab Emirates (UAE) is one of the leading agricultural producers in the Middle East. Organophosphates and carbamates are two types of pesticides commonly used to control pests that affect crop quality and production. Both types of these pesticides inhibit acetylcholinesterase activity leading to an accumulation of acetylcholine in the synaptic cleft, hyper-stimulation of nicotinic and muscarinic receptors, and disrupted neurotransmission that can cause serious neuropsychological and neuromuscular disorders. Agricultural workers may be at a high risk of inhalation, transdermal and ingestion exposure during the transportation, mixing, application and disposal of pesticides. The aim of this study was to quantify the occupational exposure to pesticides amongst agricultural workers in the city of Al Ain (UAE) prior to the start of the spraying season. Following ethical approval, erythrocyte acetylcholinesterase activity (AChE) was used to assess the extent of organophosphate and carbamate exposure in agricultural workers (n=119) currently employed as either sprayers (SPRAY; n=73) or supervisors, drivers and warehouse managers (SDWM; n=46). Participants in the SPRAY and SDWM group were involved in the handling, mixing, storage and disposal of pesticides. The SPRAY group was also responsible for pesticide application. The majority of the SPRAY group (94.5%) were from South Asia (i.e. Bangladesh, India, Pakistan) and the SDWM group were predominantly (69.6%) from other Arab countries (i.e. Egypt, Jordan, Sudan, Yemen). Mean (± SD) age of the SPRAY and SDWM groups was 37.6 ± 11.9 years and 44.3 ± 9.8 years, respectively. Mean (± SD) AChE activity was significantly lower for the SDWM group (4574 ± 1587 UI/l) versus the SPRAY group pre-spraying season (6206 ± 2309 UI/l; independent t-test t(116.06)=4.568, p<0.001, 95% confidence intervals for the mean difference 925, 2341 UI/l). A greater proportion of the SDWM group (73.9%) had a baseline AChE value classified as abnormal (normal range 5,320-12,920 UI/l) compared to the SPRAY group at baseline (34.2%; Pearson Chi-Square test χ(1)=17.761, p<0.001). Contrary to our hypothesis, pesticide exposure (indexed by lower AChE values) was greater amongst supervisors, drivers and warehouse managers compared to pesticide sprayers before the start of the spraying season. This may be due to the SPRAY group having better knowledge, attitude and practices (KAP) towards pesticides and/or the SDWM group experiencing greater occupational exposure during the transportation, storage, mixing and disposal of pesticides during the previous spraying season. Subsequent time points in the cohort study and a nested questionnaire-based KAP study will help clarify the baseline findings.