Visceral leisbmaniasis is still an endemic disease in Iraq Liver involvement is often overlooked and only little and scattered information is available. Although the disease affects primarily children under 10 years of agef as is the case in the Mediterranean basin, the identity of visceralizing Leishmania in Iraq is rather perplexing and it is not yet settled whether the Mediterranean; or the African type of parasites or a combination of the two occurs in Iraq, Thirty five Iraqi patients (ages ranging from 4 mo.- 8 years), were enrolled in the study, 22 (62.9% showed increased serum total bilirubin, 31 (88.5% increased serum total protein, 2 (5.7% decreased serum albumin, 9 (25.7% increased serum alanine aminotransferase activity, 13 (37.1%) increased serum 5-nucleotidase activity and 18 (51.4%) possessed increased serum gamma-glutamyl transferase activity. On the whole eighteen of the 35 patients (51.4%) demonstrated biochemical evidence of liver involvement. The biochemical picture coincided with the with the pathological back-ground of the disease (non-specific granuloma formation), however hepatocellular necrosis could not be excluded. According to the biochemical results obtained, patients with liver involvement were divided into four groups, where group one showedthe most severe presentation. Regirding the identity of visceralizing isolates, seven isolates obtained during the period 1988—1990 were subjected to horizontal—slab polyacrylamide gel lectro-phoresis.Five enzymes were studied: 6-phosphogluconate dehydrogenase, malate dehydrogenase, malic enzyme, glucose phosphate isomerase and phosphoglucomutase.Two WHO reference stocks were included for comparison. Six isolates were found to be similar to the Mediterranean reference stock while the seventh was similar to the Ethiopian; thus confirming the unique heterogenous make up of L. donovani stocks isolated from Iraqi children with VL. This study suggests that more attention should be paid to the role of liver involvement in the progress and prognosis of VL. and work of a larger scale on the isolation and identification of visceralizing Leishmania in Iraq is required for better understanding of the epidemiology of the disease