Objective: To identify and compare the demographic features and the clinical presentations of children with Visceral Leishmaniasis (VL) attend tertiary hospitals in two different geographical regions in Yemen.
Method: The study is a prospective study. Follow up done on children 2 weeks and wasting, hepatosplenomegaly or lymphadenopathey attending  two tertiary hospitals in Sadah and Sana'a where they investigated to diagnose visceral elishmeniasis during the period from 2006 – 2011.
Results: One hundred and ninety five (195) children were confirmed as visceral elishmeniasis, 134 from Sadah and 61 from Sana'a. The comparison of the demographic, clinical and laboratory presentation of the patients from the two areas showed that those who enrolled from Sadah have poorer presentation as weight loss (93%), malaise (86%), pallor (86%)  chest infection (6%), liver disease (5%) sickle cell anemiaand had more mortality rate.
Conclusion: VL is a common health problem and need to be addressed in Yemen. The most common presenting symptoms were fever, malaise and wasting and the most common signs were splenomegaly and anaemia. The high proportion of mortality and poor presentation in Sadah could be due to the endimecity of the disease in the area and the political and security instability in the region.