Context: Leishmaniasis (VL) is a chronic infection presents with fever, weight–loss, and splenomegaly. It‘s a mimicker of many infectious and noninfectious illnesses. Aims: We will highlight both the clinical and hematological spectrum of Leishmaniasis in the immunocompetent patients including their unusual presentations. Settings and Design: During evaluation, amastigote forms of Leishmania in bone marrow were diagnosed. In all such cases serological assay of rK39 was done which was well correlated. Methods and Material: We performed a retrospective study of 09 months at a Tertiary Health & Research Centre of Northern India. The patients presented with variable clinical features ranging from infectious etiology to malignant ones. Statistical analysis used: Being a limited number of cases, no statistical software was used. Results: Among total six patients, four presented with splenomegaly, one with renal failure and one with unilateral pleural effusion. Three and two of such patients presented with long and short duration of fever respectively and one was afebrile. Outcome of all cases was good due to timely diagnosis and management with intravenous liposomal amphotericin B. Conclusion: Diagnosis of visceral leishmaniasis can be challenging due to atypical clinical presentations at times, therefore an early investigation and prompt treatment is recommended.