Snake bite is one of the important causes of morbidity and mortality in tropical countries like India. In India, the most important venomous snakes are cobra, krait, Russell’s viper and saw-scaled viper. This study was undertaken in a teaching hospital of West Bengal to find out the epidemiological profile and clinical presentations of snake bite cases in a defined geographical area of rural West Bengal. Data were collected from the snake bite cases came to emergency and internal medicine department of a tertiary level Medical College and Hospital since March 2013 to February 2014. In the study, 685 snake bite cases were reviewed over a one year period. Most common presenting symptoms were swelling at the site of bite (56.05%) and hematuria (27.59%).18.97% cases reached hospital within 4 hours and 22.48% cases within 4 to 8 hours. 8.02% cases presented with acute kidney injury, overall mortality rate was 5.48%. Snake bite is one of the common life threatening emergencies in the study area. Delay in hospitalization is associated with poor prognosis and increased mortality.