Infection caused by Leishmania species has been increasingly reported in solid-organ transplant recipients since the first case report in 1979. Visceral leishmaniasis is endemic in central and eastern regions of India. Clinical features may simulate a variety of other infections, and a high index of suspicion is required for the diagnosis. Early diagnosis of this endemic infection is likely to result in improved outcome. We describe an unusual presentation of leishmaniasis in a kidney allograft recipient with organomegaly and pancytopenia sans fever detected by isolation of amastigotes in duodenal biopsy. To the best of our knowledge, this is the first case report of this kind in a kidney transplant recipient.