OBJECTIVES: The incidence of dengue is rising steadily in Malaysia since the first major outbreak in 1973. Despite aggressive measures taken by the relevant authorities, Malaysia is still facing worsening dengue crisis over the past few years. Dengue imposes heavy burden to health care system in terms of cost of care. This is of particular importance in resource limited setting, especially in dengue endemic regions. Although several studies have reported that dengue viral infection (DVI) is a debilitating and highly morbid condition that may cause longer bed occupancy in the hospital but very few described determinants of longer hospital stay among dengue patients. Current study was aimed to determine predictors of longer hospitalization in patients attending tertiary care hospital. METHODS: A total 468 patients with dengue infection were recruited during the period of 5 years (2009-2013). We divided all patients on the basis of length of hospital stay into two groups: patients staying ≤3 days and >3 days. Stepwise logistic regression was used to evaluate determinants of longer hospitalization.  RESULTS: Out of the 468 patients, 67.1% had stay ≤3 days and 22.9% had >3 days. The mean length of hospital stay was 4.2 ± 2.1 days. We noted that the factors independently associated with longer hospitalization among dengue patients were multiple organ dysfunctions (OR: 4.8, P<0.001), acute kidney injury (OR: 3.6, P<0.001), DHF (OR: 2.8, P=0.004), DSS (OR: 2.7, P=0.001) and age > 40 years (OR: 1.8, P= 0.014). CONCLUSIONS: Conclusively, patients with severe dengue illness accompanying by involvements of several organs and old age should be given prime importance in order to avoid their longer stay in the hospital.