PURPOSE– Himachal Pradesh, the sub Himalayan state is an endemic state for scrub typhus. Scrub typhus has a wide spectrum of presentation with propensity to involve any system/ organ. Scrub typhus clinically has been categorised into two classes i.e. mild and severe. We did a prospective study on severe scrub typhus cases. MATERIAL & METHOD– 50 patients with positive serology underwent chest radiograph and USG abdomen pelvis. Then CT thorax was done in patients having positive findings finding on chest radiograph in the form of pleural effusion, airspace consolidation, reticulonodular opacities etc. MRI brain was done in patients presented with altered sensorium, headache or loss of consciousness. RESULTS– Out of 50 patients splenomegaly was detected in 24 patients, hepatomegaly in 22, gall bladder wall thickening in 21, pleural effusion in 21, ascites in 16 patients. On CT thorax ground glass opacity in 10 patients, consolidation in 08, centrilobular nodules in 06, septal thickening in 03 patients. On MRI brain leptomeningeal enhancement with cerebral venous thrombosis seen in one patient only, out of 5 patients who underwent MRI brain. CONCLUSION – Hepatosplenomegaly(23), GB thickening(22) & ascites(12) were main findings in abdomen. Pleural effusion (21), ground glass opacity (10), consolidation(8)& septal thickening(3) were the main findings in chest. Thus, radiology aides in eliciting the spectrum of pathological findings involving multiple systems in serological positive cases.USG & chest radiograph followed by CT thorax are mainstay of radiological procedure in scrub typhus disease