Papua New Guinea reached elimination of leprosy at the national level in 2000 with a prevalence of 0.7/10,000 population. In a District Health Centre on Karkar Island in the Madang Province of Papua New Guinea there have been 5 cases reported in the last 15 years, the last of which was 10 years ago. We report a case of leprosy that was overlooked at the Outpatient Department resulting in delayed treatment due to the lack of trained staff and the unavailability of appropriate drugs. The patient was referred to the Disease Control Unit at the Modilon Provincial Hospital and commenced on multi-drug therapy 5 weeks after the initial diagnosis. This case report highlights the importance of continuous health care provider training and community awareness on diseases that have been eliminated in some provinces but not others.