OBJECTIVE: To search for hematological parameters changes in human rotavirus (HRV) infectious acute gastroenteritis in children and find useful parameters for the differential diagnosis in low re-source environments. METHODS: In this study, children less than 5 years old were divided into three groups which were rotavirus-positive acute gastroenteritis (RPAG) (101), rotavirus-negative acute gastroenteritis (RNAG) (121), and control (97) groups. First visit complete blood count (CBC) results, lymphocyte to monocyte ratio (LMR), and neutrophil to lymphocyte ratio (NLR) were recorded for each child. CBC examinations were performed using the Sysmex XS-800i hematology analyzer, while fecal HRV antigen identifications were performed by immunochromatography in fresh stool specimens. The differences in parameters among different groups were tested with SPSS 15.0. Diagnostic values were evaluated using the receive operating characteristic curve for selected parameters. RESULTS: Compared to controls, the LYM, LYM%, MPV, and LMR in RPAG were significantly lower, but the MON, MON%, NEU, NEU%, and NLR were significantly higher. Compared to RNAG, RPAG had significantly lower LYM, LYM%, and LMR and significantly higher NEU% and NLR. Among all parameters, the area under the curve (AUC) of LMR was largest when controls were used as a reference (sensitivity: 76.24, specificity: 95.88, accuracy: 85.86). However, LYM had the largest AUC when RNAG was used as a reference. CONCLUSIONS: Decreased LYM and MPV and increased NEU and MON were observed in RPAG. Low LMR and high NLR may indicate HRV infection in children with acute gastroenteritis and, therefore, can be useful markers for the diagnosis and differential diagnosis of HRV infection in low resource environments, thereby preventing overuse of antibiotics and antiviral. © 2020 by the Association of Clinical Scientists, Inc.