Background: The leishmania is an obligatory intracellular parasite that may occur sporadically, endemic or sometimes in epithemic focuses, in the whole world, and it remained a public health problem of the developing countries. In Iran, visceral leishmaniasis caused by leishmania infantum in mediteranean basin, which are epidemiological aspects of visceral leishmaniasis (Kala- Azar), is of great importance.Many regions in Iran are endemic for Kala-Azar especially in villages and every year affect some people. It will progress rapidly in young children with malnutrition.Because of leukopenia, severe decrease of polymorphonoclear (PMN) and T cell suppression, patients are susceptible to opportunistic infections and if there is a delay in diagnosis and treatment, the mortality will be increased.Methods: A retroactive cross-sectional study done to investigate case series. A total of 43 patients, 9 months to 14 years old with Kala-Azar, admitted during 8 year period (1996-2004) in infectious section of pediatrics department of Imam Khomeini Hospital were enrolled in the study.Findings: 60% were rural and under 4 years old that 28% were girls. Signs and symptoms were as following: fever 79%, pollar and cechexia and weakness 30%, abdominal distention 49%, weight lost 9.3%, hepatosplenomegaly 100% and all have BCG scar and their PPD test were negative.50% had pancytopenia, 80% had microcytic hypochronic anemia, and ESR were higher than 30 in 90%.Blood culture was positive in 11.5%, 7% had bacterial pneumonia and 93% had a positive IFA titer of 1/1280.Leishman body was positive in 79% of the first Bone marrow examinations. All these diagnosed patients treated with glocantim for 3 weeks duration. In 7% recurrence was happened.Conclusion: Any child with hepatosplenomegaly has to work up for Kala-Asar. Constantly epithemiologic assessment in endemic region can help diagnosis. Patient should start treatment with glucantim sooner. Using prevention methods (saunplies and affected dogs) can prohibit prevalence and incidence in villages.