Dengue infection is endemic in many parts of India, including the state of Karnataka. This study describes the clinical picture of dengue fever and dengue like viral infections observed by us in children admitted to a teaching hospital at Davangere. All patients admitted with a suspected diagnosis of dengue were studied in detail regarding the clinical features, laboratory profile and demographic features. Their ages ranged from 2 to 15 years with a mean of 9.5 + 3.2. our of 570 clinically suspected dengue patients, 21.6% were serologically positive and 78.4% were negative for dengue serology. Commonest presentation in dengue fever was fever (100%), retro orbital pain (61%), rash (74.8%), acute respiratory distress syndrome  (27.6%), spleenomegaly (22.8%), ascitis (22.8%) and encephalopathy in 5.7%. The commonest clinical presentation in dengue like illness were fever (98.6%), retro orbital pain (49.2%), encephalopathy (4.5%) and Malena (3.5%). Thrombocytopeina as lower than 20,000/mm³. was seen in 21.1% in dengue fever group and 14.1% in dengue like illness. Liver enzymes sGOT and sGPT were increased in both the groups. 8.1% in dengue fever group and 3.6% in dengue like illness died and the most common clinical features were ARDS and encephalopathy. The results indicated a significant proportion of children presented with little described features of splenomegaly, and acute respiratory distress syndrome. These features were not noted during the past epidemics in previous years and also there were no statistically significant difference in clinical features between dengue and dengue like illness. Hence molecular diagnosis could be the adjunt to differentiate dengue fever and dengue like illness