OBJECTIVES: Leptospirosis is a zoonotic infection endemic in Malaysia. This study was conducted to describe the clinical features and laboratory findings of leptospirosis in a tertiary care hospital of Malaysia METHODS: This is a retrospective study including 79 consecutive patients with leptospirosis admitted to tertiary hospitals in Kelantan, Malaysia from 2009 to 2011. All patients had clinical and epidemiological data suggestive of leptospirosis, and positive laboratorial test for leptospirosis were included in this study. Hospital database were used to extract all the required information RESULTS: A total of 79 patients (mean age: 36.8 ± 12.4 years) were included among them 68.5% were male. Duration of symptoms onset to hospital admission was 6.7 ± 2.6 days. The most common clinical findings among patients at admission were arthralgia (90.1%), fever (86.5%), jaundice (98.3%) and myalgia (87.2%). Other common clinical manifestations were abdominal discomfort (78.8%), lethargy (33.2%) headache (68.2%), vomiting (82.4%), bleeding (39.9%) and dehydration (72.6%). Among leptospiral intricacies hepatic failure (66.4%), acute kidney injury (69.5%), acute respiratory distress syndrome (2.2%), pulmonary failure (33.1%), visual impairments (3.6%), rhabdomyolosis (12.2%) of the patients. Thrombocytopenia and hematuria were observed in 58.3% and 34.2% of total cases respectively. Mean days of hospitalization were 6.2 ± 2.3 days. Mortality was observed in 11 cases (14%). All the fatal cases have more than one organ failure CONCLUSIONS: Leptospirosis is zoonotic fatal and highly morbid disease. Several clinical complications associated with leptospirosis lead to high mortality and morbidity. Early diagnosis and adequate management can reduce morbidity and mortality associated with leptospirosis