We report on a case of potential envenomation caused by multiple bites by the aglyphous opisthodont snake Leioheterodon madagascariensis in the left thumb of a healthy adult man, which is among the most serious snakebites hitherto reported from Madagascar. The adult snake (total length > 1 meter) was unusually aggressive before and during capture. The symptoms included extensive bleeding, severe local pain, and substantial swelling of the hand and the distal part of the lower arm. The swelling disappeared entirely after five days, but pain in the thumb (when moved) was recognizable even longer. Although L. madagascariensis is widespread and common in anthropogenic habitats in eastern and western Madagascar, this case report seems to be the first description of long-lasting symptoms of its bite. Since aglyphous snakes are relatively rarely involved in "envenomation" and because hemolytic activity has been recorded in the secretions of the Duvernoy's glands of Leioheterodon, we describe its dentition using microcomputed tomography and discuss the potential mode of envenomation in this case.