Background: Dengue heamorrhagic fever (DHF) is the severe form of dengue infection which is associated with life threatening complications such as secondary hemophagocytic lymphohistiocytosis (HLH). It is a life threatening hyperinflammatory syndrome caused by excessive immune activation. We report a 1year-8-month-old previously healthy girl who developed clinical and biochemical features fulfilling HLH- diagnostic criteria following DHF. She recovered completely without any interventions. Case presentation: She presented with fever for three days with a positive dengue antigen test. She was free of any dengue risk factors such as nonsteroidal anti-inflammatory drug usage, steroid intake, or paracetamol overdosage. She entered the critical phase of dengue on day 4 of illness making an uneventful recovery without shock, bleeding, or organ failure. Even on day 8 of illness, she continued to have persistent fever with poor general wellbeing raising the concern of evolving HLH among other possibilities. Laboratory Investigations revealed thrombocytopenia, leucopenia, hyperferritinemia (9,975 ng/mL), Hypertriglyceridemia (280 mg/dL), Hypofibrinogenemia, elevated liver transaminase levels pointing to secondary HLH. She received supportive management alone, with vigilant monitoring in case of clinical deterioration to proceed with the bone marrow examination. However, she fully recovered without receiving immunosuppressive therapy such as corticosteroids or intravenous immunoglobulin. Conclusion: This case highlights that HLH should be considered in DHF patients with persistentfever beyond the critical phase and continuing fever after the convalescent period in dengue fever. It generally warrants immunosuppressive therapy . However, in this atypical case the symptoms were resolved spontaneously though the criteria fulfilled the diagnosis HLH.