We present the case of a 43-year-old renal transplant patient who presented with fever, malaise, pruritus and severe jaundice of three weeks duration following work in a rice field. He was found to have acute renal failure (ARF) and severe hyperbilirubinemia with a positive serum leptospira antibody titer making the diagnosis of Weil’s disease. The patient responded to a reduction of immunosuppressive medications and intravenous penicillin therapy with no need for dialysis. This is the second case of leptospirosis in a kidney transplant reported in the English literature. physicians must be aware of local endemic diseases that could threaten their immunocompromised patients.