Dengue is the most common Arboviral infection in the Southeast Asia. Clinically dengue infection varies from asymptomatic infection or mild fever to severe Dengue manifestations. The aim of the study was to investigate the clinical symptoms, laboratory findings and mortality in severe dengue at a medical college hospital. In this hospital based, retrospective study, we analyzed records of all the admitted patients between July 2019 to October 2019 diagnosed to have dengue who were serologically confirmed. In this retrospective study, 256 patients were included. There were 179(70%) patients in non-severe dengue group and 77(30%) in severe dengue group. Elevated liver enzymes were observed in 230(90%) patients and 213(83%) patients had thrombocytopenia. Various atypical manifestations in patients with severe dengue were recorded. The atypical manifestations of dengue fever are no more a rare entity. Early recognition, monitoring and administration of supportive care reduce morbidity and mortality.