According to the World Health Organization, leishmaniasis is one of the seven most important tropical diseases, and it is a major global health concern. In Armenia, it is a re-emerging disease. We present a case of a one-year-old child from active visceral leishmaniasis (VL) focus with a history of intermittent fever and anemia, progressive weakness, abdominal distension with loss of appetite for 3 months. The case was confirmed as VL by a positive result for the rK39 test. Considering the symptoms and signs a combination of VL and secondary hemophagocytic lymphohistiocytosis (HLH) was suspected. The patient was treated with a 21 mg/kg total dose of AmBisome. The child responded positively to treatment, and HLH syndrome was excluded.