Background: Different methods of treatment have been used in lepromatous ulcers management, but the outcomes are frequently dissatisfactory, and many people must live with chronic wounds that result in high economic and social costs or patients have to lose the affected limb. Objective: To assess the efficacy of intralesional pentoxifylline in the treatment of lepromatous ulcers. Patients and Methods: This randomized controlled study was conducted on 40 patients with lepromatous ulcers of different size, depth and duration. Patients were divided into two groups: 20 patients as a trial group were injected intralesionally with pentoxifylline (300mg) at weekly intervals for eight sessions; and 20 patients received placebo as a control group. Lesions were photographed and the depth of ulcer was measured each session. Results: Complete closure of the ulcers was observed in 50% of lepromatous ulcers in the trial group injected with pentoxifylline and in 10% of lepromatous ulcers in control group. There were no side effects at all except tolerable pain during the injection which ended with the end of the session. Conclusion: Intralesional pentoxifylline has a great efficacy and high success rate in treatment of lepromatous ulcers.