Neurotoxic snake bites may cause paralysis within 1-8 h. Appropriate management includes early and adequate volumes of antivenom as well as ventilatory support. This case study describes the management of a pregnant woman who was bitten on a farm in rural South Africa and transferred to an academic hospital, 300 km away. An approach to the management of snake bites in pregnancy is discussed as well as a review of the current known literature of venomous snakes and the use of antivenom in pregnancy. This report aims to encourage further reporting of snake bites in pregnancy.