Cases (130) of visceral leishmaniasis (kala-azar) are reported from Fars Province, Iran. The initial clinical and laboratory presentations of patients are presented. There have been an increasing number of systemic leishmaniasis cases in this part of the world. One third of the patients were first diagnosed under 2 yr of age. Mortality was particularly high among infants. An immunofluorescence antibody titer of 1/128 or above can be applied for the diagnosis of systemic leishmaniasis.