In addition, imported cases among tourists are identified in several European countries and United States [1]. Around 100,000 cases of Chikungunya fever were reported in late December 2014, in Colombia [2]. In this article, we report a detailed description of three fatal cases with Chikungunya infection. The cases, which were treated in a University-based Hospital in Barran- quilla, Colombia, may illustrate the clinical challenges associated to the diagnosis and management of severe Chikungunya infection.