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Introduction: Black widow spider (Latrodectus mactans) envenomation is a medical challenge in regions with limited access to standardized treatments. This study analyzes a series of 10 cases that occurred in Matagalpa, Nicaragua, highlighting the diagnosis and treatment of patients. Description of the cases: Over a nine-year period 10 hospitalized patients, mostly adolescents (60%) and males (90%) from rural areas, were attended. Severe cases made up 30% of the total and included symptoms such as abdominal pain, neurogenic shock, and vomiting. Laboratory findings showed leukocytosis and lymphopenia in 50% of the patients. In terms of management, 60% received Aracmyn Plus antivenom, in addition, corticosteroids, antihistamines, and non-steroidal analgesics were used in most cases. There were no adverse reactions to antivenom treatment. All patients were discharged with no mortality. Discussion and conclusion: The lack of knowledge of this disease and the limited availability of antivenom, poses significant challenges to the effective management of latrodectism in the region. Although analgesic treatment was effective in most cases, some patients required intensive care. This highlights the need for studies that reflect local experience in managing this disease. Furthermore, this case series emphasizes the importance of publishing clinical reports in areas where latrodectism has been little investigated. These data are fundamental to generating evidence to optimize treatment and establish specific protocols in Nicaragua and similar regions.