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Background: The indigenous populations of Brazil present poor health indicators and a disproportionate prevalence and case-fatality rate of neglected tropical diseases, including snakebite envenomations (SBEs). This study aims to estimate access to medical care for SBEs and analyze the barriers that prevent victims from accessing healthcare in indigenous communities in two health districts located in the Western Brazilian Amazon. Methodology/Principal findings: This cross-sectional study used semi-structured interviews to collect data from individuals who experienced SBEs in the Upper Rio Solimões and Upper Rio Negro indigenous health districts. Of the 187 participants, 164 (87.7%) reported that they had access to healthcare and received assistance in a hospital in the urban area of the municipalities. Frequency was 95.4% in the Upper Rio Solimões SIHD, and 69.6% in the Upper Rio Negro SIHD (P<0.0001). The study found that the availability of indigenous medicine as the only choice in the village was the main reason for not accessing healthcare (75%), followed by a lack of financial resources and means of transportation (28.1%). Four deaths were reported from SBEs, resulting in a case-fatality rate of 2.1%. Conclusions/Significance: In the study areas, there are records of SBE patients who did not receive medical attention. Availability of pre-hospital emergency transport using motorboats, a greater number of hospitals and better navigability of the Solimões River and its tributaries would make access easier for indigenous people living in the region of the Upper Solimões River. The implementation of cross-cultural hospital care needs to be considered in order to reduce the resistance of indigenous populations in relation to seeking treatment for SBEs. Author summary: Interdisciplinary research on snakebites and the engagement of indigenous and riverine populations of the Amazon are essential for the formulation of innovative and tailored strategies towards achieving the global target of halving the number of deaths and disabilities due to snakebite envenomations by 2030 in Brazil. These populations are key to reducing these poor outcomes since they are disproportionately affected by snakebites. In this work, we evaluated access to medical care in SBE patients and analyzed barriers that prevent victims from accessing healthcare in indigenous villages in two health districts in the Brazilian Amazon. Snakebites were reported in all age groups, including a high rate among children, which demonstrates their great contact with venomous snakes in indigenous villages. A proportion of 12.3% of individuals with a lifetime history of snakebites did not receive hospital treatment, ranging from 4.6% in the Upper Rio Solimões health district to 30.4% in the Upper Rio Negro health district. Availability of pre-hospital emergency transport using motorboats, a greater number of hospitals and better navigability of the Solimões River and its tributaries would make access easier for indigenous people living in this district. We discuss the role that the implementation of cross-cultural hospital care, which considers specific indigenous needs for accommodation and food, may have in reducing the resistance of indigenous populations to seek western treatment for snakebites. [ABSTRACT FROM AUTHOR]