Ten patients with lepromatous leprosy have been studied to detect intranasal pathology by conventional naked eye rhinoscopy and also by use of the surgical microscope. The comparison of both methods reveals that microscopic rhinoscopy is superior in providing more accurate details of intranasal lesions in leprosy and biopsy can be taken in a precise manner from accurate and representative sites. Use of the microscope with adequate exposure and bright illumination provides precise details of lesions and an opportunity for bimanual manipulation, photography, teaching and recording. Thus, it is worthwhile to perform microscopic rhinoscopy in such cases.