Hemophagocytic lymphohistiocytosis (HLH) associated with visceral leishmaniasis (VL) in children is a rare clinicopathological entity, difficult to diagnose, fatal in the absence of treatment. It should be evoked in children with prolonged fever and splenomegaly. We report two cases of HLH caused by visceral leishmaniasis . In the first case, it was a 14-month old infant hospitalized for fever with pancytopenia. The diagnosis of HLH was made in front of a clinical and biological features, a corticotherapy was initiated. The search for an underlying infectious disease had shown the presence of leishmania bodies on the myelogram. The second case was a 15-month old infant hospitalized for fever associated with abdominal distension. The diagnosis of VL was made on the medullogram, during the hospitalization a macrophagic activation report was positive and treatment with meglumine antimoniate was introduced, the two infants had evolved well under treatment