Background: Dengue fever is a major arboviral infection causing significant morbidity in tropical countries. Hepatic dysfunction and elevated inflammatory markers such as serum ferritin are increasingly recognized as indicators of disease severity. Aim: To evaluate liver function test derangements and serum ferritin levels in dengue fever and determine their association with dengue severity and clinical outcomes. Methods: This hospital-based prospective observational study was conducted at Government Medical College, Machilipatnam, Andhra Pradesh. A total of 61 laboratory-confirmed dengue patients aged ≥18 years were en-rolled after written informed consent. Clinical details, laboratory investigations, liver function tests (AST, ALT, ALP, bilirubin, albumin), and serum ferritin levels were recorded at admission. Patients were classified accord-ing to WHO 2009 dengue severity criteria. Associations between biochemical parameters and clinical outcomes were analyzed using SPSS version 21. Results: The mean age of participants was 34.8 ± 12.6 years, and males constituted 62.3% of the study popula-tion. Elevated AST and ALT were observed in 80.3% and 67.2% of patients respectively, while AST > ALT pattern was noted in 72.1% cases. Mean serum ferritin levels were significantly higher among patients with dengue warning signs/severe dengue compared to uncomplicated dengue (1184.6 ± 472.8 vs 486.3 ± 210.5 ng/mL; p<0.001). Elevated ferritin levels were significantly associated with plasma leakage, bleeding manifesta-tions, ICU admission, and prolonged hospitalization. Conclusion: Liver function test abnormalities and elevated serum ferritin levels are significantly associated with dengue severity and adverse outcomes. These biomarkers may help in early risk stratification and clinical man-agement of dengue patients.