Hemophagocytic syndrome (HPS) is a rare clinicopathological condition resulting from dysregulation of the immune system. This unusual clinical syndrome is characterized by fever, cytopenia, liver dysfunction, increased ferritin level and hemophagocytosis of bone marrow. We report a case of a 40 year old male with severe leptospirosis and secondary hemophagocytosis who presented to us with high grade fever and jaundice and later was complicated by multi organ dysfunction and death despite aggressive management. Our case highlights leptospirosis as a rare cause of HPS. A high index of clinical suspicion and prompt treatment for HPS in patients with severe leptospirosis with progressive multi-organ dysfunction despite antimicrobial therapy, is very important as the condition otherwise carries a very high mortality.