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OBJECTIVE: To describe a young patient who had a Bothrops envenomation (BE) and evolved with shock and subcapsular liver hematoma. Moreover, a review on BE and liver hematoma was also performed. PATIENTS AND METHODS: A systematic screening of articles was conducted and all articles on the association between BE and liver hematoma were included. A new case report is added to the published list. The following terms were used: "Bothrops" and "liver hematoma" or "liver hemorrhage." RESULTS: This literature search found only one article describing one patient with BE and liver hematoma. We performed our analysis by adding our present case, with a total of 2 cases. Both patients came from Brazil. One of them needed blood transfusions. They both had a good outcome. CONCLUSIONS: We systematically reviewed all published cases of BE and liver hematoma. It is a rare manifestation of ophidism. Physicians should be alert for patients with shock or abdominal pain after BE; they need to perform an ultrasound to exclude liver hematoma.