This is the first systematic review of studies done since 1960, and to give an integrated picture of pesticides exposure to humans, animals, plants, waters, soils/sediments, atmosphere etc. in Pakistan. Authors have extracted data from different departments, published literature in research journals and National reports. Although the wide-spread usage of pesticides in Pakistan has controlled the pests, but like other countries, it has started causing environmental problems in the area. In some areas of Punjab and Sindh groundwater has been found contaminated and is constantly being under the process of contamination due to pesticide use. There is considerable evidence that farmers have overused and misused pesticides especially in cotton-growing areas. It is evident from the biological monitoring studies that farmers are at higher risk for acute and chronic health effects associated with pesticides due to occupational exposure. Furthermore, the intensive use of pesticides (higher sprays more than the recommended dose) in cotton areas involves a special risk for the field workers, pickers, and of an unacceptable residue concentration in cottonseed oil and cakes. The authors have also discussed the merits and demerits of different studies. The review will set the future course of action of different studies on pesticide exposure in Pakistan. Data limitations are still the major obstacle towards establishing clear environmental trends in Pakistan. The authors suggest that a reliable monitoring, assessment and reporting procedures shall be implemented in accordance with appropriate environmental policies, laws and regulations in order to minimize the pesticides exposure.