Background: Leprosy is a chronic granulomatous disease affecting skin and nerves. The nerve damage that occurs in lep-rosy is the most serious aspect of this disease as nerve damage leads to progressive impairment and disability. It is important to identify markers of nerve damage so that preventive measures can be taken. Objective: To evaluate anti-ceramide antibody as a reliable marker in the assessment of nerve damage in paucibacillary and multibacillary leprosy patients. Patients and Methods: The present study included a total of 50 leprosy patients (25 paucibacillary and 25 multibacil-lary) and 50 healthy controls. Serum levels of anti-ceramide antibody were measured using enzyme-linked immunosorbent assays (ELISA). Results were reported in optical density (OD) units as mean±SD and analyzed by Chi square test (significance at p