Kala azar is a disease endemic to the Sudan and a cause of major morbidity and mortality to affected patients when the diagnosis or treatment has been delayed. In this report we described the clinical features of 99 parasite proven patients with visceral leishmaniasis. The Sudanese kala azar patient is young in age (teens to 20's), has marked weight loss despite a continuous, excellent appetite and suffers from insomnia, epistaxis and abdominal pain. Hepatosplenomegaly is universally present. Generalized lymphadenopathy is a prominent feature (72%). The high prevalence of lymphadenopathy has a wide range of implications: for diagnosis, i.e., the use of lymph node aspiration; for response to treatment, i.e., the resolution of lymphadenopathy; and for studies of immunoregulation in this systemic infection.