<p class="abstract"><strong>Background:</strong> Leprosy is a chronic infectious disease which predominantly involves skin and peripheral nerves. Most important consequences of leprosy are due to the involvement of peripheral nerves which leads to gross deformities and disabilities. Detection of preclinical nerve function impairment can help in the prevention of deformities and disabilities. The objective of the study was role of nerve conduction study (NCS) to detect nerve function impairment (NFI) in leprosy.</p><p class="abstract"><strong>Methods:</strong> An electrophysiological study was conducted for 50 newly diagnosed cases of leprosy from December 2017 to July 2019 at Department of Dermatology, Osmania Medical College, Hyderabad. Nerve conduction velocities, amplitude, and latencies of ulnar, median, common peroneal, posterior tibial, sural nerves are measured.<strong></strong></p><p class="abstract"><strong>Results:</strong> 10 nerves in each patient with a total of 500 nerves were studied by NCS. Only 8 (16%) cases had totally normal NCS. And rest 42 (84%) cases have abnormal NCS. Most common pattern observed is sensory motor axonal neuropathy. A total of 268 (53.6%) nerves were normal before starting multidrug therapy and 232 (46.4%) nerves have abnormal NCS. Among these nerves the involvement of Sensory nerves (49%) are more than motor nerves (42%).</p><p class="abstract"><strong>Conclusions:</strong> NCS is a reliable and reproducible test to detect the early NFI. Though it cannot directly diagnose leprosy, it can be used in suspected cases, newly diagnosed cases, and household contacts to detect the NFI early and prevent the complications associated with it.</p><p> </p>