Leptospirosis is a widespread zoonotic disease that is commonly seen in temperate and tropical areas. Here, we have presented a case report of fatal leptospirosis with thrombocytopenia and renal failure. A 22-year-old male soldier was referred to the infectious diseases clinic with complaints of fever, headache, dizziness, sore throat, and weakness. He had a history of staying in a village and tick removal from his head. An extended polymorphic rash on the whole body, congestion on the sclera, hyperemic pharynx, and hepatomegaly were observed. Laboratory examination revealed leukocytosis and impaired liver and kidney function tests. Antibiotic therapy with penicillin G and gentamicin was started with the pre-diagnosis of leptospirosis. The main diagnosis was confirmed by passive hemagglutination test positivity. On day 5 of treatment, bleeding continued, and hemodialysis was performed. The patient died on day 6 of treatment. The physicians should be aware about the clinical presentations of Leptospira infections in endemic areas.