Background: Leptospirosis is a zoonotic disease of worldwide distribution caused by Leptospira genus bacteria. Weils disease is a form of severe leptospirosis with conjunctival suffocation, jaundice, and acute kidney injury. Methods: We present a case of suspected Weils disease patient in our health care unit in rural hospital area. Complimentary databases were collected from PubMed and Scholar Google. Case Illustration: A 43 years old male, came to the ER complaining of fatigue followed by calf aches. He is a farmer who always goes barefoot. Icterus was found in the whole body, especially the sclera. Gastrocnemius muscle pain was also present. Laboratory examination shows leukocytosis and thrombocytopenia with elevated liver and renal function tests. There is no specific laboratory test for leptospirosis available in our health care unit. The patient was suspected of Weils Disease based on history taking, physical examination, and general laboratory test. Injection of antibiotics and oral drugs were given to the patient. Discussion: Leptospirosis is one of the most highly prevalent in tropical countries with 73% of cases, particularly in South-East Asia. An increase in urea and creatinine in patients is a sign that strongly suggests Weils disease. The diagnosis, in this case, did not use direct or indirect tests of leptospira due to limited equipment in hospitals located in rural areas. Conclusion: The diagnosis of leptospirosis in this case was based on a history of high-risk patient occupation, accompanied by clinical symptoms and general laboratory results.