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Cardiotoxicity in snake envenomation has not been adequately explored in the literature. This retrospective, observational study analysed clinical profiles and cardiovascular effects (CVE), with associated outcomes, in snake envenomation. Thirty-four patients were recruited between April 2014 and October 2017. Cardiovascular involvement was seen in 24 (70.6%) patients. Electrocardiographic changes included prolonged QTc (62.5%), T-wave inversion (37.5%) and tall T-waves (12.5%). Hospital stay was 7.2 (SD = 5.3) days and 4.4 (SD = 2.4) days in CVE and non-CVE groups respectively ( P value = 0.04). Mechanical ventilation was required only in nine of the CVE group (37.5%; P value = 0.03). Shock was observed in seven patients (20.6%). Two of the patients in the CVE group (5.9%) died ( P value = 1.0); the majority had good outcomes with early administration of anti-venom serum and appropriate supportive measures. Thus, inpatient stay and mechanical ventilation were significantly increased in snake envenomation with CVEs, especially where an underlying co-morbidity existed. [ABSTRACT FROM AUTHOR]