BACKGROUND Dengue fever is a tropical, vector-borne infection caused by Flaviviridae, transmitted by the bite of Aedes mosquito. Dengue fever is predominantly asymptomatic but common clinical manifestations include fever with thrombocytopenia induced bleeding tendency, myalgia, arthralgia. Renal involvement in dengue is attributed to pre-renal Acute Kidney Injury. Dengue fever induced thrombotic microangiopathy is very rare. We present a case of Dengue fever induced Thrombotic microangiopathy.