It is the smallest member of the "big four" Indian snakes that are responsible for causing the most snakebite cases and deaths, due to various factors including their frequent occurrence in highly populated regions, and their inconspicuous nature.

[2][6] The color-pattern consists of a pale buff, grayish, reddish, olive or pale brown ground color, overlaid mid-dorsally with a series of variably colored, but mostly whitish spots, edged with dark brown, and separated by lighter interblotch patches.

The top of the head has a whitish cruciform or trident pattern and there is a faint stripe running from the eye to the angle of the jaw.

On the Indian subcontinent it is found in India, Sri Lanka, Bangladesh, and Pakistan (including Urak near Quetta and Astola Island off the coast of Makran).

In the Middle East it is found in Oman, Masirah (Island), eastern United Arab Emirates, Iraq, and southwestern Iran.

[13] Echis carinatus is found on a range of different substrates, including sand, rock, soft soil and in scrublands.

Specimens have also been found in Balochistan at altitudes of up to 1982 m.[2] Echis carinatus is mostly crepuscular and nocturnal, although there have been reports of activity during daylight hours.

[2] During the daytime they hide in various locations, such as deep mammal burrows, rock fissures and fallen rotted logs.

[2] Echis carinatus is one of the species responsible for causing the most snakebite cases due to their inconspicuous and extremely aggressive nature.

Its characteristic pose, a double coil with a figure of eight, with the head poised in the center, permits it to lash out like a released spring.

[8] Echis carinatus feeds on rodents, lizards, frogs, and a variety of arthropods, such as scorpions, centipedes and large insects.

In northern India, mating takes place in the winter with live young being born from April through August.

In severe cases the swelling may extend up the entire affected limb within 12–24 hours and blisters form on the skin.

Even though many other snake venoms contain similar toxins, echistatin is not only especially potent, but also simplistic in structure, which makes it easier to replicate.