Intravenous antivenin requirements to neutralize venomous snake bites can be appropriately calculated based on accurate estimations of injury severity, and/or safely titrated if systemic symptoms are present. This report describes a case in a child given 13 10-ml vials of crotalidae antivenin before and during transfer, and tetanus prophylaxis, cephalosporin (200 mg IV q 6 h), and the titration of 62 additional 10-ml vials of antivenin within 14 hours, based on the child's response to therapy. By the tenth day all symptoms had resolved.