Snake venoms have a variety of effects on the clotting cascade and endothelium. Recent clinical studies have provided important insights into venom-induced consumption coagulopathy (VICC) in Australian snakes. VICC is associated with sudden cardiac arrest, major haemorrhage, thrombotic microangiopathy and acute renal failure. Although antivenoms have been the mainstay of snakebite treatment for many years, the results of our studies challenge the assumption that antivenom works. A recent randomised controlled trial of clotting factor replacement for VICC with fresh frozen plasma (FFP) has been completed, demonstrating the efficacy of this treatment. This presentation will review the findings of these studies and the impact on the management of snakebite in Australia, then consider broader implications for the management of snakebite in general.