Diquat is a non-selective, fast-acting herbicide belonging to the bipyridinium class of pesticides like paraquat. With the ban on paraquat, acute poisoning incidents involving diquat have been increasing yearly. However, the understanding of the injury mechanisms and clinical manifestations of acute diquat poisoning remains insufficient. This article reviewed the treatment of two cases of acute diquat poisoning leading to osmotic demyelination syndrome (ODS) in the Characteristic Medical Center of Chinese People's Armed Police Force, and summarized similar cases by searching Chinese and English databases including CNKI, Wanfang, and PubMed, using keywords "Diquat" and "Poisoning/Intoxication/Toxicity/Overdose." Among 12 patients, there were five males and seven females, with an average age of (32.6±16.3) years. Ingestion doses ranged from 50 to 120 ml, with coma being the most common clinical manifestation, reflecting significant impairment of consciousness. MRI findings typically showed low signal intensity on T1-weighted sequences, and high signal intensity on T2-weighted and FLAIR sequences in damaged areas including the pons, thalamus, and basal ganglia. Two patients died, while ten survived, with four survivors experiencing severe sequelae. This study suggests that in patients with acute diquat poisoning presenting with consciousness disorders such as coma, clinicians should be alert to the potential development of ODS and consider performing early MRI examination. While most of these patients have a good prognosis, some may develop severe sequelae, which warrants attention.