Leptospirosis is a zoonosis of ubiquitous distribution, caused by infection with pathogenic Leptospira species. The spectrum of human disease caused by leptospires is extremely wide, ranging from subclinical infection to a severe syndrome of multiorgan infection with high mortality.(1)Cardiovascular implication in leptospirosis is infrequent we Report a 39 year old farmer who had jaundice ,abdominal pain, vomiting along with dry cough ,breathlessness, oliguria and massive pericardial effusion following a short febrile illness which required mechanical ventilation and renal replacement therapy. His diagnostic workup revealed leptospirosis and workup for TB was negative. The patient presented a good response to the treatment, being discharged from hospital completely asymptomatic, with no pericardial effusion.He was evaluated again one month later, with no trace of effusions or symptoms.