Objective: The objective of the study was to determine clinical presentation and outcome of patients presented with snake bite. Study design: Prospective follow up study Place and duration of study: Department of medicine, Medical unit I, Chandka Medical College Teaching Hospital, Larkana from April date to November 2009. Patients and methods: Patients with snake bite admitted in Medical unit I were included in the study after taking informed consent. The demographic and clinical presentation was recorded in preformed proforma. After initial stabilization patients were followed daily till discharge. Descriptive statistics were computed for demographic and clinical features. Logistic regression was done to identify factors associated with poor outcome. Results: During eight months study period 135 cases presented in ED of CMCH with history of snake bite. Mean age of participants was 26.3±5.2 years. Gender distribution revealed that 81.5% were males and male to female ratio was 4.6:1. Univariable analysis showed Age OR (95%CI) 1.14 (1-1.3), bleeding 4.91 (1.03-23.38), swelling 8.05 (1.01-64.36), neurologic signs 15.45 (3.84-62.13) and treatment by faith healers 4.19 (1.03-23.38) were the predictors of death. Multivariable analysis showed that Age 1.5 (1.12-2.14), presence of neurologic signs 13.6 (2.06-89.82) and treatment by faith healers 29.1 (2.52-336.4) were independent predictors of death. Conclusion: It is concluded that age, presence of neurologic signs and treatment by faith healers is independent predictors of death in case of snake bite. This may provide important evidence in order to formulate preventive strategies.