Introduction: Leptospirosis is a bacterial zoonosis of worldwide distribution. Its clinical presentation is highly variable in terms of signs and severity. Weil's disease is characterized by the association of conjugated hyperbilirubinemia, sometimes severe, with hemorrhagic manifestations including hemoptysis and gastrointestinal bleeding. Case presentation: We report the case of a 27-year-old woman admitted to the intensive care unit for management of a hemorrhagic syndrome. She initially presented with an influenza-like illness treated by self-medication with paracetamol. On admission, the patient presented with febrile hepatonephritis associated with multiorgan failure, together with the classic triad of Weil's disease: conjugated hyperbilirubinemia, and hemorrhagic manifestations including hemoptysis and gastrointestinal bleeding. Leptospira IgM serology was positive, confirming the diagnosis. She was treated with ceftriaxone and supportive care. The clinical course was favorable, with discharge from the intensive care unit after 10 days of hospitalization. Conclusion: The presence of a hemorrhagic syndrome in the setting of febrile hepatonephritis should raise suspicion of human leptospirosis. Patient history-taking is essential and may reveal exposure to animals capable of transmitting the pathogen to humans. Definitive diagnosis relies on isolation of the organism or rapid IgM serological testing.