This article reports an unusual case of neuropathic orofacial pain secondary to leprosy. To the authors' knowledge, it is the first case of leprosy reported in the Western literature that was initially thought to be dental pain, then mistaken as a temporomandibular disorder before the correct diagnosis was made. The patient had migrated to Australia from India 24 years previously and was otherwise healthy without any overt features suggestive of infection. A review of the literature revealed that the trigeminal nerve is frequently involved in leprosy, usually associated with sensory loss rather than neuropathic pain. Even in Western countries, patients originally from countries where leprosy is endemic may develop symptoms of the disease many years later. The possibility of leprosy should be considered in the diagnosis of neuropathic orofacial pain in such patients. Schlagwörter: leprosy, neuropathic pain, orofacial pain