Although snake bites are fairly common in the United States, with more than 60,000 occurring each year, venomous snake bites are comparatively rare, with only approximately 7000 per year ( 1 Deaths resulting from animal attacks in the United States.

Wilderness Environ Med. 1997; 8: 8-16

, 2 Incidence and mortality due to snakebite in the Americas.

PLoS Negl Trop Dis. 2017; 11 (e0005662)

). Sistrurus miliarius, or the pygmy rattlesnake, is a venomous snake endemic to the southeastern United States ( 3 Gold BS Barish RA Dart RC. North American snake envenomation: diagnosis, treatment, and management.

Emerg Med Clin N Am. 2004; 22: 423-443

, 4 Patel V Kong EL RJ Hamilton. Rattle snake toxicity.

StatPearls [Internet]. StatPearls Publishing, Treasure Island, FL2021

). A majority of pygmy rattlesnake bites are dry and do not require antivenom ( 3 Gold BS Barish RA Dart RC. North American snake envenomation: diagnosis, treatment, and management.

Emerg Med Clin N Am. 2004; 22: 423-443

). This article documents the progression of a pygmy rattlesnake bite of the finger with envenomation, which was not treated with antivenom.