Indira Gandhi Medical College, Shimla receives referred patients of pyrexia with multi-organ dysfunction during the monsoon season from all over the state of Himachal Pradesh. Most common etiologies of pyrexia are enteric fever, scrub typhus, malaria, viral, tubercular, and some patients of dengue fever from adjoining states. Leptospirosis has not yet been reported in sub-Himalayan state of Himachal Pradesh, India. We present here a case of leptospirosis presenting as ARDS, proven on IgM Elisa and confirmed by PCR. Leptospirosis is a new etiology in this region for patients presenting with pyrexia and ARDS.