Whether a bite or sting results in an anaphylactic reaction, impressive local effects, or a life-threatening systemic reaction, the emergency physician must be able to institute appropriate and effective treatment. Emergency physicians also must be able to recognize clinical envenomation patterns, since some critically ill patients may not be able to convey the details of the “attack.” Since all areas of the country are represented in the envenomation statistics, all emergency physicians should be familiar with identification and stabilization of envenomated patients and know what resources are available locally for further management of these often complicated patients.