Background & Aim: Leprosy a chronic infectious public health challenge is caused by a slowly multiplying acid fast bacillus Mycobacterium leprae. An untreated leprosy-affected person is the only known source of infection. Our aim was to study the trend in the prevalence of leprosy in the health care facility, to compare the leprosy burden in urban and rural field practice area under the health facility, to identify any gaps/loopholes in the implementation of the NLEP and to recommend remedial measures to address the gaps. Materials and Methods: A cross sectional study was conducted at Community Health Centre Jatni, Khordha, Odisha during the year 2018-19. A pre-designed questionnaire, personal interview with multipurpose health worker male and review of leprosy records of different years was used as study tool. Results: Majority i.e., 78.6% of the leprosy patients were from rural areas. Overall male predominance of the cases was found both in urban & rural areas. More numbers of cases were registered during 2014-15 & 2015-16 which was declined in 2016-17, but again increased in the subsequent years i.e., 2017-18 and 2018-19. 61.8% diagnosed leprosy cases had successfully undergone treatment and got cured and 24.4% of the cases were the defaulters to MDT. Conclusion: Defaulter cases are the major source of continuous transmission of infection in the community. Active surveillance for Leprosy is to be strengthened in both rural and urban areas with special focus on IEC and BCC activities along with proper counseling of the family members with involvement of community people.