Leprosy is a rare chronic infectious disease that can be challenging to diagnose in non-endemic settings due to limited experience among doctors, and clinical heterogeneity. We report a leprosy case in a Nordic patient with an extensive travel history who presented with skin lesions and peripheral neurological symptoms. The histopathological results were non fully specific, but modified Ziehl-Neelsen staining revealed large numbers of acid-fast bacteria in the tissue samples. Mycobacterium leprae was identified based on molecular analyses. To avoid delayed treatment and prevent progression of the disease, an overview of histopathological features of leprosy and its differential diagnosis is provided.