Background: Hantaviruses are a large group of RNA viruses that belong to the genus Hantavirus, family Bunyaviridae. This pathology has a wide clinical spectrum from mild to moderate forms to fulminant hemorrhagic. Albania as well as Bulgaria, Greece and the former Yugoslavia have severe forms of the disease. Case presentation: We presently report a case of a 44-year-old men resident of Tirana city who was hospitalized at the UHC of Tirana. He had history of traveling sixteen days before to the Albanian Alps. He complained of diarrhea with blood content, nausea, vomiting, abdominal pain, headache, fever, myalgjia since three days. The physical findings included hypotension, tachycardia, tachypnea, hyperemia of the face and Murphy’s sign. The first laboratory examinations showed hemoconcentration, decrease in platelet count, renal and hepatic alterations as well as increased of pancreatic enzymes. He was transferred to the intensive care unit due to severe alteration in vital parameters. Urine analysis showed proteinuria of 6.61 g/liter/24 h and he had increase in creatinine 12.9 mg /dL and urea 207 mg /dL. The situation precipitated to oligoanuria, severe hypotension, dyspnea. The patient underwent hemodialysis sessions. ELISA IgM and IgG antibodies for anti-Hantavius resulted positive. The patient was successfully treated with antiviral and supportive treatment and was discharged in good clinical conditions 39 days after the onset of this severe illness. Conclusions: Hemorrhagic fever with renal syndrome shows a very diverse clinic. So by knowing its clinic well and getting complete epidemiological information, we can diagnose it quickly and accurately