Introduction: We report a case of severe systemic copperhead, Agkistrodon contortrix, envenomation that resulted in long-term sequelae.

Case Report: A 72-year-old man presented to the emergency department after suffering a copperhead snakebite. He developed severe systemic toxicity before local tissue injury developed. Clinicians did not initially recognize his envenomation syndrome and sought alternative explanations for his systemic symptoms before polyvalent immune fab (ovine) antivenom was administered. Although the patient improved, he was discharged with new stage three chronic kidney disease.

Conclusion: Although rare, copperhead envenomation can cause severe systemic toxicity. Envenomation should be promptly treated with antivenom.