Pathological findings have been described in only a small number of cases of Lassa fever since the virus was first isolated in 1969. Morphologically, eosinophilic necrosis of hepatocytes was the most frequent finding and focal necroses, often extensive, were present in most cases. These findings are similar to the lesions previously described in Argentinian and Bolivian haemorrhagic fever. Focal interstitial pneumonitis, focal tubular necrosis in the kidney, lymphocytic infiltration of the splenic veins, and partial replacement of the splenic follicles by amorphous eosinophilic material have been described, but the significance of these findings is unclear. More detailed and sophisticated investigations are required in the future if pathogenetic mechanisms are to be unravelled.