The direct immunogold silver staining (D-IGSS) method was used to detect the viral antigen in the extremity blood of 67 cases of hemorrhagic fever with renal syndrome. The positive rate of viral antigen was the highest during the fever, hypotension and oligouria phrase; and the rate dropped gradually during the polyuria and convalescent phase. It is suggested that clinical staging was positively related with the percentage of the viral antigen positive cells (P < 0.001). It is concluded that the positive rate was related to the extent of the injuries by direct viral attack and immune reaction. The D-IGSS was proved to be fast, simple, economical, with high sensitivity and specificity.