Objective Analyzing and summarizing the characteristics and clinical data of 238 cases of unexplained fever in patients with normal or decreased white blood cell count, to guide the clinical diagnosis and treatment in feverish pa-tients with normal or decreased white blood cell count.Methods In the department of hematology 238 cases of fever in pa-tients with normal or decreased white blood counts have been collected from January 2009 to December 2013.Retrospectively analyze their clinical manifestations, related auxiliary examination, and diagnostic process and treatment.Results 234 cases in the total 238 cases had confirmed diagnoses, of which the rate was 98.3%.Of the total 238 cases, 176 cases (73.8%) were diagnosed with infectious diseases; 17 cases (7.2%) were diagnosed with malignancy; 6 cases (2.5%) were diag-nosed with connective tissue disease;35 cases (14.8%) were diagnosed with other diseases;diagnoses of 4 cases (1.7%) were not confirmed.Conclusion Most patients with fever can have a confirmed diagnosis after a detailed history and physical examination.The main cause of fever is infection.Fevers with normal or decreased white blood cell count have their particular clinical manifestations which should be concerned, targeted and treated accordingly as soon as possible.