Introduction - This study presents an epidemiological overview of leptospirosis in French Polynesia (FP) from 2006 to 2008. Method - Clinical data obtained from the PMSI and clinical information forms, as well as laboratory test results, were collected and analyzed for 2006, 2007, and 2008. Results - The average annual incidence is high (35 per 100,000 inhabitants); the majority of reported cases are hospitalized (67%), of which 33% require admission to the intensive care unit. The clinical signs and reported risk factors are typical. Cases are found year-round and across all the archipelagos. Discussion - With an incidence far higher than in mainland France, leptospirosis is a public health concern in French Polynesia. Despite the availability of a PCR technique for early diagnosis, 40% of cases are diagnosed via serology (which can be performed starting on the 5th day of illness). Conclusion - Lifestyle factors (walking barefoot, swimming, subsistence farming) make it difficult to strictly enforce personal protective measures. The surveillance system must be improved to include an investigation of each reported case. Information and awareness campaigns targeting healthcare professionals and the general public will be implemented. (R.A.)