Echis carinatus a saw-scale viper (locally called Lundi) regarded as one of the most venomous snakes of Pakistan and worldwide and is responsible to cause more snakebite deaths than any other snake. In this study, purification, characterization and pharmacological studies of Ec venom from Pakistan have been performed. The results revealed that Ec venom is mainly composed of metalloprotease, serine protease, L-amino acid oxidase, phospholipase A2 (acidic, basic and neutral), disintegrin, C-type Lectins and CRISP as established by combination of various modern techniques including RP-HPLC, 1D/2D PAGE, shotgun LC-MS-MS and other proteomics tools. Rabbit intestinal nerve muscle preparation was used for physio-pharmacological studies. Results demonstrated that Ec venom had an irreversible inhibition effect on the contractile force of smooth muscle. Venom also caused inhibition in contractures induced by ACh and KCl in relation to time and in dose dependent manner. This inhibition appeared to be due to myotoxic components responsible for the blockade of L-type calcium channels. However, the inhibitory response of venom was abolished when venom was heated at 100°C suggesting its proteinaceous nature. Moreover, it was also observed that when gut bath temperature was lowered (37°C to 26°C) or Ca+2 concentration was increased (from 2.5 to 5 mM), it did not abolish the inhibitory effect of venom on the intestine. The neutralization of Ec venom induced toxicity by the available antivenoms was also targeted. It is worth mentioning here that in absence of locally produced antivenoms, Pakistan is solely reliant on antivenoms produced in other neighboring countries such as India and Saudi Arabia. Considering well established fact that inter- and intra- species variations in venom composition is a key determining factor in the neutralization efficacy of antivenoms, also provides good rational for thorough screening. Thus, two different commercially available polyvalent antivenoms and a genus specific monovalent sera (as control) were subjected regarding their efficacy against Ec venom neutralization and it was observed that prior administration (10 min) of polyvalent antivenom BPAV from India partially neutralized and prevented the complete inhibition in smooth muscle contractile force. However, it failed to neutralize venom effect when added at t50. While another polyvalent i.e. PSA from Saudi Arabia showed immediate decline in active tension even before the administration of venom and this effect persisted even after the administration of venom. This indicated antivenom total ineffectiveness and the presence of some impurities, probably some muscle relaxants that immediately reduced the muscle contractile force. In contrast, monovalent Echis specific antivenom (MSAV) showed the most effective neutralization than the other two polyvalent antivenoms. These pharmacological findings were further complemented by using other modern techniques such as SEC FPLC and DLS, while the quality of antivenoms was tested by 1D PAGE, SEC FPLC and CD spectroscopy. In conclusion, our findings strongly suggest the need for local production of genus specific antivenoms for the treatment of this clinically important snake bite in Pakistan.