Virus associated hemophagocytic syndrome(VAHS), a class II histiocytosis syndrome, is characterized by high fever, liver dysfunction, coagulation abnormalities, and generalized histiocytic proliferation with marked hemophagocytosis in bone marrow and lymph nodes. VAHS is associated with several viral infections including Epstein Barr virus which has a relatively high mortality rate. We report a fatal case of Epstein Barr virus associated hemophagocytic syndrome and its diagnosis by mRNA in situ hybridization and polymerase chain reaction. A brief review of related literaure is also presented.