Introduction Hansen’s disease is chronic systemic and granulomatous disease by Mycobacterium Leprae. It principally affects peripheral nerves, skin and mucous membrane. Lepromatous leprosy harbors large numbers of bacilli. Objective To review the effectiveness of leprosy contact tracing programme in Kelantan. Methods This is a 10 year retrospective analytical study of new leprosy cases in Kelantan, Malaysia from 2001 to 2010. Routine contact tracing plus 2 intensive home visit surveys were performed in year 2002 and 2006. Results 108 and 87 home visits were made in 2002 and 2006 respectively. 638 adults and 416 child contacts were examined in 2002 while 512 adults and 403 children were examined in 2006. 90% contact tracing were achieved. 127 new leprosy cases were detected from 2001 to 2010 of which 108 (87%) were adults and 16 (13%) children. In adults 63 (58%) and 45 (42%) had multibacillary and paucibacillary respectively. In children, 4 and 12 had multibacillary and paucibacillary leprosy respectively. 90% of the new leprosy in children were detected through contact tracing. One family had 5 children who developed leprosy from contact to index. 2 children had ulnar palsy and another child had type 1 MDT reaction. Conclusion The increased risk of contacts getting leprosy especially in paediatric patients, neccessitate yearly contact tracing for early detection treatment in children and reduce deformity in children. Management to include counselling, surveillance to all leprosy patients and insist on regular slit smear.