Snakebite envenoming is a significant global health issue, causing mortality and severe morbidity. Venom toxins are responsible for cardiovascular disturbances, neurotoxicity, and acute kidney injury, while tissue-damaging toxins cause cell destruction and extracellular matrix degradation. These toxins are classified based on their mechanisms of action rather than the tissues they affect. Tissue-damaging toxins include cytotoxic toxins and ECM-degrading enzymes. Cytotoxic toxins directly damage cells, while ECM-degrading enzymes may indirectly damage cells by disrupting the extracellular matrix. These toxins cause various pathologies, including myonecrosis, dermonecrosis, and acute kidney injury. The classification of these toxins is often based on the tissues they affect, but this is not mechanistically accurate. A new classification based on the mechanisms of action is proposed. The review discusses the molecular mechanisms of venom-induced tissue damage and their clinical implications. It highlights the need for a better understanding of these mechanisms to develop novel therapeutic options. The review also discusses the clinical consequences of tissue-damaging activities of venoms, including local and systemic effects. The review emphasizes the importance of understanding the mechanisms of cytotoxicity to develop effective treatments for snakebite envenoming. Current treatments include antivenoms, but their efficacy in neutralizing local tissue damage is limited. New therapeutic strategies are needed to address this issue. The review also discusses the development of enzyme inhibitors that can neutralize venom components, such as PLA2s and SVMPs. These inhibitors have shown promise in reducing tissue damage and are being tested in clinical trials. The review concludes that a better understanding of the mechanisms of venom-induced tissue damage is essential for developing effective treatments for snakebite envenoming.Snakebite envenoming is a significant global health issue, causing mortality and severe morbidity. Venom toxins are responsible for cardiovascular disturbances, neurotoxicity, and acute kidney injury, while tissue-damaging toxins cause cell destruction and extracellular matrix degradation. These toxins are classified based on their mechanisms of action rather than the tissues they affect. Tissue-damaging toxins include cytotoxic toxins and ECM-degrading enzymes. Cytotoxic toxins directly damage cells, while ECM-degrading enzymes may indirectly damage cells by disrupting the extracellular matrix. These toxins cause various pathologies, including myonecrosis, dermonecrosis, and acute kidney injury. The classification of these toxins is often based on the tissues they affect, but this is not mechanistically accurate. A new classification based on the mechanisms of action is proposed. The review discusses the molecular mechanisms of venom-induced tissue damage and their clinical implications. It highlights the need for a better understanding of these mechanisms to develop novel therapeutic options. The review also discusses the clinical consequences of tissue-damaging activities of venoms, including local and systemic effects. The review emphasizes the importance of understanding the mechanisms of cytotoxicity to develop effective treatments for snakebite envenoming. Current treatments include antivenoms, but their efficacy in neutralizing local tissue damage is limited. New therapeutic strategies are needed to address this issue. The review also discusses the development of enzyme inhibitors that can neutralize venom components, such as PLA2s and SVMPs. These inhibitors have shown promise in reducing tissue damage and are being tested in clinical trials. The review concludes that a better understanding of the mechanisms of venom-induced tissue damage is essential for developing effective treatments for snakebite envenoming.