Nearly 4,000 snakebites are annually reported in Colombia -90-95 % are inflicted by pit vipers from Bothrops, Porthidium, Bothriechis, Bothriopsis, and Bothrocophias genera, specially by B. asper (50-80 %); 2 % by the bushmaster Lachesis spp.; 1 % by the rattle snake Crotalus durissus cumanensis; 1 % by coral snakes (Micrurus spp.); and the remaining 1-5 % by snakes of aglyphous and opisthoglyphous dentition, mainly from Colubridae family. The Colombian fatality rate of snakebite envenoming is 1-3 %, the highest percentage in the Orinochian and Amazonian regions, whereas 6 % of patients suffer some type of sequelae, mainly as a result of dermonecrosis and myonecrosis. B. asper is responsible for 60-90 % of deaths secondary to snakebites. In this chapter, the clinical and epidemiological aspects of bothropic, lachesic, crotalic, and elapidic envenomations are described, with specific features for the country, as well as the actual knowledge of venom composition and actions.