Leptospirosis is a ubiquitous and potentially fatal zoonosis with protean manifestations. Human infection commonly occurs through contact with contaminated water or soil. In developed countries, leisure or household activities are increasingly associated with the disease. Within few months, we encountered five unrelated and autochthonous cases of severe leptospirosis, three of them requiring interim dialysis. In this case series, we present their clinical course. Furthermore, we provide an overview on the spectrum of organ involvement, with an emphasis on kidney injury, and comment on pitfalls in establishing the diagnosis. The considerable variance in presentation—with admissions both to internal and neurological units—emphasises the high index of suspicion required to arrive at the right diagnosis, particularly in countries of perceived low risk such as Austria.