Surgery was conducted on 140 patients with pit viper bites. The effects of envenomation, methods of treatment and results of the bites in this series of patients are reviewed. Opening the bite site surgically, debriding the wound and performing fasciotomy where necessary prevented the further loss of tissue at the bite site, relieved the pain and prevented crippling. One death occurred in an 85 yr old woman; other sequelae of the bites included crippling in 3 patients, infections in 2 (Escherichia coli and Staphylococcus aureus), skin grafts and hepatitis. Antivenin should be reserved for the most serious bites. Hydrocortisone sodium succinate relieves the toxic systemic effects of envenomation and apparently does not interfere with healing or cause any side effects.