The innate immune system constitutes the first line of defense against viral agents, and NK cells seem to have an important protective role during the early phases of influenza virus infections. We decided to assess the levels of NK and NKT lymphocytes and the expression levels of different membrane receptors (NKp44, NKp46, NKG2A, killer cell immune-like receptor [KIR] 3DL1/ DS1, KIR2DL1/DS1, and CD161) in peripheral blood samples of patients with influenza (n ؍ 17) and healthy individuals immunized against this virus (seasonal and [H1N1]pdm2009 influenza vaccines; n ؍ 15 and 12, respectively). Blood samples were obtained from all individuals, and NK and NKT cell subsets were analyzed by multiparametric flow cytometry. We found that the patients with severe influenza (n ؍ 9) showed significant increases in the percentages of NKp46 ؉ NKp44 ؉ NK cells and the proportions of NK and NKT lymphocytes expressing KIR2DL1 and KIR3DL1 and reductions in the percentages of NKp46 ؉ NKp44؊ NK cells compared to those in the healthy controls (n ؍ 27). In contrast, influenza immunization, against either the seasonal or the pandemic H1N1 virus, was not associated with important changes in the levels of NK and NKT lymphocytes or the expression levels of the different receptors by these cells. Our data suggest that severe influenza is associated with important and complex alterations on NK cells, which might contribute to the pathogenesis of this condition.