Aim and background: Capillary leak syndrome (CLS) following Russell's viper envenomation is a rare potentially fatal complication, even after administration of adequate antisnake venom. Case description: Here, we present the case of a 54-year-old male who presented with snakebite and subsequently developed CLS, characterized by conjunctival congestion, parotid swelling, hypoalbuminemia, and albuminuria. The patient experienced severe third-space fluid loss necessitating aggressive intravenous fluid resuscitation to maintain intravascular volume. Despite these efforts, renal hypoperfusion requiring dialysis and respiratory distress necessitating mechanical ventilation ensued. Through vigilant intensive care unit (ICU) monitoring and management, the patient eventually recovered without complications. Conclusion: This case underscores the importance of early identification of CLS and the need for close ICU monitoring, intensive ventilatory, and circulatory support. For guideline-directed and targeted therapy, future research of this lethal syndrome is imperative. Clinical significance: This article is to increase awareness regarding recognizing this rare fatal complication, overview of management, and emphasizing the importance of initiating early treatment that plays a significant role in recovery.