Introduction: There are approximately 3000 species of snakes existing in Earth, of which only 600 species are poisonous. Snake population, venom composition and related human health hazards are variable in geographic areas and seasons. Aims: To work out predictive factors of requirement of Invasive and Non-Invasive Ventilation in Neurotoxic snake envenomation. Materials and Methods: The present study was a Prospective, observational and analytical study. This Study was conducted for one year at N.R.S. Medical College and Hospital, Kolkata Result: In our study, Krait bite was responsible for maximum no. of envenomation in the study population (69%) followed by unknown snake bite (21.5%), whereas cobra bite was least among study population (9.5%) and Maximum no. of patients presented to Health Centre within 6 hours, where they were given initial 10 vials of ASV (69%). Conclusion: Presence of dysphagia, pain abdomen, ophthalmoplegia, hypotension and others (neck weakness, limb weakness and unconsciousness) were found to be statistically associated with development of respiratory paralysis.