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Background: Leprosy is a chronic, infectious disease caused by Mycobacterium leprae. It mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and the eyes. Nerve damage may result in lack of ability to feel pain, which can lead to loss of parts of a person's extremities from repeated injuries or infection due to unnoticed wounds. Egypt is one of the first countries in the region to achieve the elimination target at the national level as early as 1994, However Leprosy is still endemic in certain foci in Egypt. Thus, our study aims to evaluate the epidemiology of leprosy in Elqalaah leprosy clinic in Cairo over the last decade to support the current national control program of leprosy with updated data. Objective: This study presents an analysis of pattern of new cases of leprosy detected annually from 2009 to 2020 in Elqalaah Dermatology and leprosy clinic in Cairo as the new-case detection rate is better than prevalence as an indicator of disease trends. Methods and Material: Data about patients with newly diagnosed leprosy were collected from Elqalaah dermatology and leprosy clinic registry, the main referral center in Cairo governorate. Case detection rates (CDR) were calculated for each year by dividing the newly diagnosed cases by mid-year populations for the same year. Results: 504 patients were newly diagnosed between 2009 and 2020. The mean age of patients at diagnosis was 38.16 years, 64.5% were males, and 5.4% were children below 14 years of age. The new case detection rate ranged from 0.66/100,000 population in 2009 to 0.12 /100,000 population in 2020. 82.5% were classified as multibacillary. 75.6% were detected by notification method, and 82.5% of patients completed their treatment course. Macules was the most common clinical finding and was found in 67.7% of patients. 18.5% of cases had previous history of contact with other leprosy patient. 13.1% and 2.4% suffered type one and type two leprae reactions respectively. 11.9% of cases had grade two hand disabilities, 6.7% had grade two feet disabilities and 1.8% had grade two eye disabilities. Conclusions: The new case detection rate is acceptable compared to the global level and there was a decline in the number of cases throughout the years of the study, however community- based research should be encouraged and leprosy trends over years from different regions need to be reported to know the actual status of leprosy in different regions of country and continued surveillance of patients and their contacts is required to detect relapses and undiagnosed cases. [ABSTRACT FROM AUTHOR]