Introduction: Leprosy caused by Mycobacterium Leprae is an important public health problem. It is a chronic granulomatous disease involving skin and peripheral nerves. Histopathological examination of skin provides confirmatory diagnosis in suspected cases and gives indication of progression and regression of disease under treatment. The aim of this study is to identify the clinical pattern of leprosy and its clinicohistopathological correlation. Methods: Clinico Pathological study of 35 leprosy patients was undertaken in the Department of Pathology. Biopsies were taken from most active skin lesions by Department of Dermatology and fixed in 10% formalin. The tissue section stained with Hematoxylin and Eosin and Fite Faraco staining for identifying the bacilli. Histopathological findings were graded according to Ridley and Jopling scale. ClinicoHistopathological correlation was done. Results: Maximum numbers of patients were in their 3rd Decade (28.57%).Males were contributing to majority of the patients (72.5%). One case that we received of LL type was a male. In the clinical spectrum of 35 cases, IL was not contributing to any clinical diagnosis, TT was in 1 (2.85%) case, BT in 19 (54.28%) cases, BB in 5 (14.28%) cases, BL in 5(14.28%) cases, and LL in 5 (14.28%) cases. Common type of skin lesion observed was Macule (54.28%). Commonest site of lesion was Trunk and Upper Limbs (22.85%). Most of the cases were presented as Hypopigmented Lesions (65.71%). Most of the patients showed Anesthetic Lesion (48.57%). In the histopathological spectrum IL cases were contributing to 48.57% of cases, TT cases were 2.85%, BT cases were 25.71%, BB cases were 2.85%, BL cases were 17.14%, LL cases were 2.85%. Overall concordance between Clinical and Histopathological diagnoses was 20%. Conclusions: Clinical examination or histopathological examination alone may not stand as ideal diagnostic tools in diagnosing and classifying leprosy. There are factors like interobserver variation, overlap between different types of leprosy. Clinico histopathological disparity may be reduced by following the criteria strictly both clinically and histopathologically there by providing the patient early and adequate treatment to prevent morbid disabilities. 

Keywords: Leprosy; Histopathology; Ridley-Jopling.