Sixty-three patients with acute renal failure (ARF) following snake bite were treated in the Intensive Care Unit of Hospital das Clínicas of Federal University of Minas Gerais. In 32 patients (51%) ARF followed Bothrops snake bite and in 31 patients (49%) followed Crotalus durissus terrificus snake bite. The main complications presented by the patients were uremia (all cases), hyperpotassemia (89% of the cases), anemia (78% of the cases), urinary tract infection (37% of the cases), overhydration (17% of the cases), cardiac arrest (14% of the cases) and acute pulmonary edema (11% of the cases). Five patients bitten by Crotalus durissus terrificus (16%) presented acute respiratory failure attributed to the neurotoxic venom action and four of them recovered completely. Seven patients bitten by Bothrops snakes (22%) had renal cortical necrosis. In five patients the diagnosis of this complication was made by renal biopsy and in two patients it was made at necropsy. Seventeen patients were given conservative treatment for ARF. Peritoneal dialysis was necessary in 45 patients (71%) and hemodialysis in two patients, one of them had also received peritoneal dialysis. Fifty-five patients were discharged from the hospital, four of them with chronic renal failure secondary to renal cortical necrosis, and eight patients died (13%). Deaths were attributed to acute pulmonary edema in four patients, to shock in two patients and to coma and pulmonary infection following cardiac arrest in two patients.