Discard "Volcanic Shell" to the Graveyard with it's effect you can pay Life Points and get another "Volcanic Shell" from your deck to your hand to use "Reptilianne Medusa"'s effect again.
You can combo this card with "Reptilianne Scylla" to get your opponent's monster (without its effect) on your side of the field in face-up defense position.
Use its effect, then equip "Heart of Clear Water". Use "Mask of Restrict" to prevent your opponent from tributing the monster. Then, all you have to do is keep attacking the monster to do a lot of damage each turn.
Use "Reptilianne Spawn" to summon two tokens and tribute one of them to summon this card. Then, use this card's effect in an opponent's monster and tribute the remaining token along with the monster to special summon "Reptilianne Vaskii".
You can use the effect of this card alongside with "Reptilianne Poison", each one used on different opposing monsters, then tribute them to special summon "Reptilianne Vaskii". With this, you'll get rid of 2 of your opponent's monsters and will be able to attack with 2 powerful monsters.
If your opponent has a remaining monster after this, you can use the effect of "Reptilianne Vaskii" and destroy it.
If you are battling an opponent who has a very powerful monster (e.g. "Slifer The Sky Dragon"), this card's effect can be used to good results.
"Sinister Serpent" can be discarded repeatedly to use "Reptilianne Medusa's" effect, as it will return to the player's hand during their next Standby Phase.