Introduction: Scrub typhus is acute febrile illness caused by Orientia tsutsugamushi an endemic disease occurring throughout the Indian subcontinent.(1) Incidence of scrub typhus has risen many times in Himachal Pradesh mainly during rainy season due to exposure to vegetation while working in fields. Acute onset fever, headache ,Eschar and rash are clues for early diagnosis. Several factors have been suggested to be associated with severe complications(14). We carried out this study to study a new usable tool R factor as prognostic indicator in patients of scrub typhus. Results: A total of sixty patients were studied who presented with acute onset fever and were IgM scrub positive. . Patients were studied for outcome which was discharge or death which ever was earlier. . Patients were studied for outcome which was discharge or death which ever was earlier. . In patients who expired mean R–factor was 5.1(hepatocellular) and the one who survived mean R factor was 1.02 (cholestatic). Over all the R–factor was found to be significant (p=.017) for death in scrub typhus. Conclusion: This study explicitly explains the usefulness of R factor as a prognostic marker in patients with scrub typhus. Hepatocellular injury was found to be most important and had a poor prognosis