Summary Sporadic kala-azar is known to occur in northern and central parts of Tunisia. It predominantly affects children. In this report, the authors describe the first four cases in adults originating from central Tunisia. Fever, anemia and splenomegaly were the common clinical manifestations. Three patients had hepatomegaly, with biological abnormalities in two of them. None had evidence of immunosuppression. The diagnosis was made by finding Leishmania amastigotes in bone marrow aspirates and/or indirect fluorescent test for Leishmania antibodies. Parasites were demonstrated in two lymph node biopsy specimens. All patients had complete resolution of symptoms after receiving two 10-days cures of Glucantime ® in a dose of 65 mg/kg per day. There were no adverse side effects of treatment.