The five-paced viper (Deinagkistrodon acutus) is a prevalent venomous snake in China. Its venom comprises metalloproteinases, phospholipase A2, C-type lectin-like proteins, and serine proteases, which can induce acute reactions such as tissue inflammation, edema, necrosis, hemorrhage, coagulopathy, and even multiple organ failure. This report details a case involving a child in a rural area of China who was accidentally bitten by Deinagkistrodon acutus while playing outdoors and subsequently died despite treatment. The autopsy findings and histopathological results may assist in the clinical management and forensic practice related to Deinagkistrodon acutus envenomation in the future.