OBJECTIVE The objective of the following study is to assess the clinical profiles and manifestations of snakebite patients in the rural hilly setting of Shivalik and the Lesser Himalayan region of Himachal Pradesh. METHODS A hospital record-based retrospective descriptive study was carried out that included details on demography, clinical profile, treatment and outcome among 200 patients over a period of 2 years. The data was analyzed using Chi-square test for comparison. RESULTS 142 (71%) patients were young (age group of 16-45 years) and the number of male patients was 118 (59%) and female patients were 82 (41%). All the cases recorded presented in the months of April to November. Not a single case was recorded from December to March. The most frequently bitten sites were the lower limbs particularly the feet. 86 (43%) of the patients presented without any features of envenomation. Neuroparalysis was the commonest presentation in 53 (46%) patients followed by hemotoxicity in 36 (31%) among symptomatic patients. Early morning neuroparalysis syndrome was the presentation in 26.4% patients. Allergic reactions in the form of early anaphylaxis were noted in 7% patients. CONCLUSIONS Snake bite is a neglected tropical disease affecting poor villagers in rural areas. Future research focusing on understanding epidemiological determinants of snake bite is desired.