In terms of venomous bite caused by Bungarus multicinctus, the characteristic wounds are painless and even without any signs of envenoming. Many emergency physicians give patients antivenom based on snake identification, fang marks and early signs of tissue necrosis, e.g., blistering, bleeding, swelling or redness. If the bites were not witnessed or unable to describe the snake species, there might be delay in diagnosis and initiation of antivenom injection. The patients' condition may deteriorate rapidly, leading to mechanical ventilation use. Earliest signs of neurotoxic envenoming such as ptosis, diplopia or early restriction in mouth opening should be closely monitored. An optimal dosing (3 to 4 vials) of antivenom is recommended for patients with definite systemic or local signs of envenoming. We report a case with obvious fang marks suffering from neuromuscular syndrome even after three vials of antivenom given within one hour. Fortunately, his general conditions recovered after 6 days of intensive care without mechanical respiratory support.