Objective: Snake bites by Bothrops lanceolatus are a typical medical emergency in Martinique (30 cases/year). The first specific antivenom (Bothrofav®), made in 1993, led to a reduction in mortality. However, a recent increase in cases of ischemic stroke induced by envenoming, despite early serum infusion, suggested a decreasing efficiency. A new specific antivenom (Bothrofav®) was registered in February 2011. Clinical use of a de novo F(ab’)2 Bothrofav preparation (Bothrofav®2) in Martinique restored safety and complete effectiveness. Almost 76 patients have been successfully treated with Bothrofav®2 since 2011 without fatal cases or neurovascular complications. The objective of this study was to evaluate its safety and efficacy in a prospective series of treated patients