The case reports of 54 patients from 2 to 16 years of age admitted with snake bite to Port Moresby General Hospital, Papua New Guinea, over a period of 38 months were reviewed. The case fatality rate was 7.7%. The commonest pattern of toxicity was a combination of neurological deficit and coagulation disturbance, but other patterns were recorded. Treatment included antivenom in 49 patients and endotracheal intubation in 16. The response to treatment was analysed to discover factors associated with a complicated course or a fatal outcome. Early administration of antivenom reduced the need for intubation. Reactions to antivenom were reduced by the use of hydrocortisone and promethazine together. Children 5 years of age or less formed a high risk group. Recommendations are made concerning the use of antivenom, hydrocortisone plus promethazine, and intubation, which may result in the saving of both lives and money.