Background: Leprosy continues to be a predominant public health problem in India despite rapid strides made for its prevention, detection and treatment since ages. As leprosy can occur in any form due to immunological status of the patient, its clinico-pathological correlation gains more importance. Aim: The present research was undertaken to ascertain the importance of skin biopsy in detecting and diagnosing difficult cases where clinical diagnosis alone is not sufficient and a clinico-pathological correlation study in leprosy assumes greater significance. Method: This was a hospital based prospective study conducted in 60 cases of clinically diagnosed, newly untreated or suspected cases of leprosy for two years among patients attending OPD Department of Dermatology and whose skin biopsies were processed in the department of Pathology with Haematoxylin & Eosin stain along with special stain (Fite Faraco) to ascertain clinico-pathological correlation in leprosy cases. Results: A total of 60 cases were studied. Out of them 71.7% were males and 28.3% females. Majority of them 31.7% belonged to the age group of 21-30 years and children were least affected. Clinico-histopathological classification concordance was noted maximum in LL (80%) followed by BT (77.2%), TT (76.4%), BL (75%), BB (71.4%) and least in IL (60%). Overall concordance between clinical and histopathological diagnosis observed in our study was 75%. Conclusion: Diagnosing and treating leprosy solely on clinical basis still poses a problem while histopathology helps in making a definite diagnosis. This study shows a good correlation among clinical and histopathological findings in skin biopsy.