Leprosy is a chronic granulomatous disease, affecting the skin and Schwann cells of peripheral nerves. In most leprosy cases, the nasal mucosa is affected. We aimed to describe the clinical changes in nasal mucosa using nasal endoscopy, in patients with leprosy attending a dermatology service in an endemic region and compare this changes with those founds in non-leprosy patients nasal mucosa. This crosssectional study examined and compared 16 leprosy patients and 16 non-leprosy patients. Nasal endoscopy was conducted in both groups to determine differences between the two groups and analysis was applied to evaluate factors related to changes in the nasal mucosa. A larger number of changes in the nasal mucosa was observed in multibacillary patients (75%); infiltration, lepromas and hematic crusts were the changes that were most commonly observed. There was a larger proportion of men (68.8%) diagnosed as having leprosy; they demonstrated a 23-fold increase of nasal mucosa involvement compared to women. There was no positive correlation between nasal symptoms and changes observed in the nasal mucosa. Therefore, it is important to perform an otorhinolaryngological examination and, more importantly, an endoscopic examination of the nasal mucosa, regardless of the presence or absence of symptoms or the clinical presentation of patients with leprosy.