Background: Crimean-Congo hemorrhagic fever (CCHF) is an endemic zoonosis in Kastamonu, Turkey. Clinical and laborato- ry findings may not be specific in the early phase of the disease, hence bringing a challenge to the clinician. Objective: We aimed to distinguish CCHF cases among all suspected cases by comparing them with non-CCHF cases with respect to characteristics during admission.Methods: Cases with a presumptive diagnosis of CCHF at a secondary care hospital in Kastamonu in between 2014-2017 were evaluated, retrospectively. CCHF and non-CCHF cases were compared with respect to their clinical, laboratory and epidemio- logical characteristics during admission.Results: Among 76 suspected patients, CCHF was found in 46.1% of them. Four-year fatality rate was 9.6% in CCHF cases. The frequency of headache, nausea/vomiting, leukopenia, thrombocytopenia less than 50x109/L, AST-ALT and LDH elevation, tick bites and contact with blood or body fluids of animals in CCHF cases were significantly higher than in non-CCHF cases (p<0.05).Conclusion: Headache and nausea/vomiting accompanied with leukopenia, thrombocytopenia less than 50x109/L, AST-ALT and LDH elevations raise the possibility of CCHF in endemic regions especially when there is a history of tick bite and contact with blood or body fluids of animals.Keywords: Crimean-congo hemorrhagic fever, Kastamonu, Turke