This was a prospective evaluation of four immunodiagnostic assays for human leptospirosis, including the indirect immunofluorescence test (IFA), the microscopic agglutination test (MAT), the LEPTO dipstick, and the latex agglutination (LA) test. Four hundred ninety-two serum samples were collected from 348 patients who presented with acute fever without localizing signs. The sensitivities of the IFA, MAT, Dipstick, and LA were 91.9, 76.6, 77.4, and 83.1%, respectively. The specificities of these assays were 100.0, 100.0, 89.3, and 83.5, respectively. Even though IFA showed the highest overall sensitivity and specificity, when acute sera were considered, the LA was the most sensitive (28.7%). All 3 genus specific antibody assays had broad reactivity against various serogroups. The MAT is best suited for the reference laboratory, where it can be maintained with the battery of live antigens; the IFA is suited for a laboratory with sophisticated equipment and technical expertise; the Dipstick and LA are suitable for peripheral laboratories which lack expensive equipment and expertise.