Leprosy is one of the most common treatable dermato-neurologic disease affecting skin and peripheral nerves. Though the prevalence of the disease is decreasing, still it is a major public health problem in India. Pure neuritic leprosy constitutes 4 – 10% of all leprosy cases. The diagnosis of such case is difficult because of lack of skin lesions. Therefore it requires high degree of suspicion and thorough investigations. Association of anaemia with leprosy is commonly due tonutritional and impaired utilization of iron and studies have quoted impaired iron metabolism and defective megaloblastic erythropoiesis. Our case is a pure neuritic form of leprosy with unusual finding of ulnarcystat right elbow joint and also had severe degree of Iron Deficiency Anemia. It was a diagnostic challenge requiring high degree of clinical suspicionand thorough investigations.