Stingray injuries to humans are common in warm coastal areas. Wounds have a traumatic (puncture) component and a toxic (envenomation) component. The puncture component is like a stiletto-type knife wound, most often inflicted on the lower leg (waders) or arm (fishermen). Rare puncture injuries to the thorax or abdomen can cause serious injuries and death. Envenomation causes intense pain that is out of proportion to the apparent injury. The pain of stingray envenomation is relieved with hot-water immersion of the injured part, although the exact mechanism for this well-established phenomenon remains unclear. Current recommendations for treating stingray wounds are reviewed.