Objective To understand the clinical characteristics and changes in laboratory indicators of patients died of visceral leishmaniasis (VL). Methods Clinical data of 4 patients died of VL in Beijing Friendship Hospital from January 2013 to June 2018 were analyzed, differences in laboratory indicators were compared. Results Disease course of 4 cases of VL ranged from 3 to 12 months, all patients had multiple organ damage, including 3 cases with hepatomegaly and splenomegaly, 2 cases with central nervous system damage. IgG antibodies of leishmania were positive in 4 patients, Leishman-Donovan body was found in bone marrow smears. Routine peripheral blood test results in 4 patients decreased significantly, albumin decreased significantly and globulin increased; level of serum sodium ion in 4 patients was lower than 135 mmol/L. Conclusion Long disease course, multiple organ damage, involvement of central nervous system, significant reducing in peripheral blood routine test results, hypoproteinemia, and hyponatremia in patients with VL all indicate poor prognosis and high mortality.