Objective To study the dynamic changes of soluble intracellular adhesion molecule-1 (sICAM-1), and to assess its role in the pathogenesis of hemorrhagic fever(HFRS) with renal syndrome. Methods A total of 30 patients with HFRS(case group) and 20 healthy subjects (control group) from Worker Hospital of Finance & Commerce of Qiqihar city were included in the study during 2006 - 2007. Double-antibody sandwich ELISA method was used to measure the level of sICAM-1 in serum samples. Results The serum levels of sICAM-1 in patients with HFRS in early stage, critical stage, convalescent stage were(47.56±6.51), (94.23±15.36), (54.19±8.42)ng/L,respectively. The serum level of sICAM-1 in control group was (22.63±3.40)ng/L. The above values were compared between any two groups, differences were statistically significant (all P < 0.01). The serum level of urea nitrogen in patients with HFRS in early stage, critical stage, convalescent stage were (5.16±0.12), (33.84±9.24),(8.20±1.30)mmol/L, respectively. The serum level of urea nitrogen in control group was (4.20±0.56)mmol/L.The above value were compared between any two groups, the differences were statistically significant (all P< 0.01). Conclusions sICAM-1 is involved in the pathogenesis of HFRS as protective factors. Cellular immune playes an important role in the pathogenesis of HFRS.