INTRODUCTION: Leprosy is a fairly dreaded disease, but it is curable. However, liver failure is one of the side effect of the treatment that challenging to manage.OBJECTIVES: Assessing the effects of Multi Drug Therapy (MDT) on the liver function (SGOT, SGPT) and Mycobacterium Leprae Particle Agglutination (MLPA) test (IgM anti PGL-1) before and after treatment in patients with multibacillary (MB) leprosy.METHOD: Twenty-eight patients who met the inclusion criteria were enrolled in this study which categorized as new MB leprosy patients in Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia. In order to test the liver function, blood serum was taken to measure the SGOT and SGPT level with Bochringer Mannheim automatic analysis, while MLPA test measurement was performed with qualitative method. Blood serum was collected three times with the following period; before the treatment, 3 months, and 6 months after treatment. The data was analyzed using Friedman and Wilcoxon Signed Rank test with significant level p<0.001.RESULT: There were significant increases in SGOT and SGPT levels (p<0.001) before and after MDT treatment between 3 to 6 months. Meanwhile, for IgM anti PGL-1, it was not significant (p>0.01) before treatment and after 3 months treatment, but significant different (p<0.001) on 6 months treatment.CONCLUSION: MDT treatment on MB leprosy patient increase the SGOT and SGPT level but decrease the IgM anti PGL-1 after the 6 months of treatment.