Calcium gluconate and methocarbamol were compared by using an algorithmic treatment protocol on all cases of Latrodectus (black widow) envenomation seen over a period of 3 years. Six of 13 patients were effectively cured of their symptoms by calcium gluconate, while only one of 10 patients was relieved by methocarbamol. Calcium gluconate remains the drug of first choice for this syndrome. It was also noted that calcium gluconate was more effective in patients who presented 3 hours of more after they were bitten. Antivenom may be necessary in those who present with symptoms in less than 3 hours.