Dengue is an emerging pandemic-prone mosquito-borne viral infection which causes a flu-like illness, and sometimes severe dengue. Most of the patients diagnosed to have dengue fever present with gastro-intestinal manifestations along with classical viral symptoms. The present study was conducted to outline spectrum of gastro-intestinal manifestations in dengue fever patients in rural population. Methods: Total 50 patients with Dengue fever were taken as test subjects under this cross-sectional observational study. A detailed and thorough clinical history and physical examination was performed and relevant investigations were done. Gastro-intestinal manifestations were noted and correlated. Results: Out of 50 patients under study 54% (27) were males and 46% (23) female with male to female ratio of 1.17:1. Gastrointestinal manifestations were noted in form of nausea and vomiting in 38% (19) of patients while pain abdomen in 20% (10) and loose stools in 12% (6) of patients respectively. Abdominal tenderness was noted in 28% (14) of patients, out of which 22% (11) of patients had tenderness in epigastrium and 6% (3) had tenderness in right hypochondrium. Liver function derangement was noted in form of elevated SGOT in 74% (37), elevated SGPT in 58% (29), transaminitis in 62% (31) of patients while hyperbilirubinemia was noted in 6% (3) of patients. SGOT was found to be elevated more as compared to SGPT. Ultrasound of abdomen showed evidence of ascites in 20% (10) of patients while gall bladder wall edema was noted in18% (9), hepatomegaly in 16% (8) and splenomegaly in 10% (5) of patients. Conclusion: Gastrointestinal manifestations are most common presenting manifestations in patients with dengue fever with varying spectrum. Evidence of abdominal pain and tenderness, transaminitis, gall bladder wall edema and ascites on ultrasound are indicators for intensive therapy. Presence of acalculous cholecystitis, acute pancreatitis and acute fulminant hepatitis indicate severe disease. Dengue fever should be considered as probability in patients presenting as acute febrile illness with gastrointestinal symptoms in endemic areas.