One hundred twenty-nine cases of visceral leishmaniasis (kala-azar) seen over a thirteen year period in a nonendemic area at a referral medical center in north India are described. The epidemiological, clinical and therapeutic features of these patients are presented. A large number of patients came from nonendemic areas and showed some unusual clinical and laboratory features. Use of sodium antimony gluconate led to relapse in approximately 34 percent of cases. Lack of awareness of the occurrence in a nonendemic area and the unusual manifestations may cause considerable difficulties in establishing the diagnosis.