The Brown recluse spider has emerged into a potent venomous creature. Loxoscelism and necrotic arachnidism is not an infrequent medical problem. Spiders other than L. reclusa are capable of inflicting painful and persisting necrotic wounds, however, management of the local cutaneous lesions are similar. Systemic complications of loxoscelism appear to be characteristic for spiders of the genus loxosceles. The authors review an indepth discussion of the spider, venom, diagnosis, clinical presentation, laboratory findings, treatment, and prevention. The literature on loxoscelism is contradictory because of the individuality of the reaction. Experience with many patients is the only guide to management of these cases.