Introduction: Pyrexia of unknown origin may pose significant diagnostic challenge. We herein report a case of PUO where diagnosis became really difficult. Malignancy can be lurking behind in such cases. Case description: We present a case 9–year–old boy with pyrexia of unknown origin of 1 year duration. Even after elaborative investigations his diagnosis remained elusive. Eventually laparoscopic splenic biopsy was performed and revealed splenic Hodgkin lymphoma Conclusion: Laparoscopic splenic biopsy can provide a middle path to reach diagnosis with minimum complications and should be considered early in diagnostic ladder.