Hemorrhagic fever with renal syndrome (HFRS) is the most common natural focal infection registered in the Republic of Tatarstan. Basically, HFRS affects people of working age, the proportion of children is 2.4%. The purpose was to study the clinical features of the HFRS course in children. Material and methods. We examined 40 children aged 1 to 17 years with HFRS hospitalized at the Republic Clinical Hospital in 2017–2021. All children were divided into 2 groups according to pubertal age: group 1 consisted of 12 children aged 0 to 8 years, group 2 consisted of 28 children aged 9 to 17 years. Results. It was found that children under 8 years were characterized by a milder course of the disease with predominance of infectious-toxic and abdominal syndromes without kidney damage. In children over 8 years old, the disease had a more striking clinical picture, manifesting as infectious-toxic, abdominal syndromes, visual disturbances in the form of foggy vision, kidney damage (decreased diuresis, increased blood creatinine and urea levels), in single cases – effusions into pleural cavity, pericardium, abdominal cavity and pelvic cavity.