The emergence of dengue hemorrhagic fever in Sri Lanka in 1989 correlated with the appearance of a genetic variant of Dengue 3 virus (DENV-3) subtype III (group B), closely related to the endemic group A variant. We studied the 5' and 3' non-coding regions (NCRs) of 15 DENV-3 subtype III isolates from Sri Lanka, Nicaragua and Martinique and found variability in the 3' NCRs. This included an 11-nucleotide insertion common to all isolates examined and two nucleotide differences that segregated viruses geographically into an American and a Sri Lankan group. Comparisons also identified three nucleotide differences shared by all group A Sri Lankan DENV-3 III isolates linked to mild disease epidemics but not group B Sri Lankan and group B-associated American isolates linked to severe disease epidemics. Clustering of the Latin American/Caribbean isolates with Sri Lankan group B DENV-3 in phylogenetic analyses supports the proposed common East African origin for all these strains and confirms the use of the 3' NCR for molecular epidemiologic studies of DENV-3. The differences in the 3' NCRs reported here, as well as potential alterations in the structural and non-structural coding genes, may contribute to the increased pathogenicity of group B DENV-3.