Tissue destruction, not death, is stressed as the major medical problem arising from snake bite in the United States. Case histories are presented contrasting the effects of pit-viper bite when treated with or without cryotherapy. A seven-step regimen to prevent death and tissue destruction through the use of ligature and cryotherapy is presented. Emphasis is placed on the importance of using iced water initially, followed by a complete and continuous coverage of the envenomed member with finely divided ice. It is also stressed that success in the use of cryotherapy is dependent upon a careful consideration of the ambient temperature. Supporting therapy is also suggested stressing the following: (a) a more effective and conservative use of incision and suction; (b) the possibilities of increased tissue destruction by the improper use of antivenin; (c) a warning against utter disregard of the principle of chemical compatibility when selecting supporting therapeutic agents. A documented discussion of the wide margin of safety involved when using cryotherapy and the value of the ligature are given in conclusion.