Abstract: Objective To investigate the clinical features and prognostic factors of hemorrhagic fever with renal syndrome ( HFRS). Methods The 131 HFRS patients were divided into blood purification group and non-blood purification group.We retrospectively analyzed their epidemiological data，clinical manifestations，laboratory findings，prevalence of complications and outcomes，and discussed the factors associated with the prognosis of HFRS. Results Most of the HFRS patients were young and middle-aged men which engaged in agriculture, and HFRS mostly occurred?in autumn and winter. In most patients, the course of disease was not typical of the five-phase evolution process, and the symptoms of "three pain" and "three red" were rare. The major clinical manifestations were fever, nausea, and vomit, poor appetite, proteinuria，conjunctival hyperemia, and edema, etc. The major laboratory findings were leukocytosis, thrombocytopenia，increased serum creatinine, and urea, increased glutamic-oxalacetic transaminase and glutamic-pyruvic transaminase, etc. Multivariate Logistic regression analysis revealed that leucocyte counts?（OR 1.137403，95%CI 1.008838～1.282352，P=0.035）and multi-organ failure（OR 1514.407，95%CI 4.366992～525173.5，P=0.014） were independent risk factors for the prognosis of HFRS. Conclusion The clinical manifestations of HFRS are complex and diverse, and typical cases are fewer,often accompanied by various degrees of injury in multiple organs?and?multiple systems