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Abstract : Arboviral transmission through transplanted organs is rare. We report a highly probable case of dengue viral transmission during live donor liver transplantation. Fever with severe thrombocytopenia was observed in the donor and recipient within 6 and 9 days after transplantation, respectively. Dengue diagnosis was confirmed by testing blood and explant tissue from donor and recipient using dengue specific NAT (nucleic acid testing) and serology. Serology indicated the donor to have secondary dengue infection that ran a mild course. However, the dengue illness in the recipient was severe and deteriorated rapidly, eventually proving fatal. The recipient's explant liver tissue tested negative for viral RNA indicative of a pre-transplant naïve status. The prM-Envelope gene sequence analysis of the donor and recipient viral RNA identified similar serotype (DENV1) with almost 100% sequence identity in the envelope region. Molecular phylogenetic analysis of donor and recipient viral envelope sequences with regional and local dengue strains further confirmed their molecular similarity, suggesting a probable donor to recipient transmission via organ transplantation. Screening of living donors for dengue virus may be considered in endemic regions. This article is protected by copyright. All rights reserved.