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Leprosy is a chronic infectious disease with major involvement in the skin and peripheral nervous system caused by the bacterium bacillus Mycobacterium leprae. Borderline lepromatous (BL) is one of leprosy types characterized by annular with poorly demarcated outer borders and sharply defined punch out centers. This case report aimed to know and establish the diagnosis of multibasillary leprae borderline lepromatous. A 65 year old man came with a complaint of numbed erythematous patches. Smear test showed the presence of IB + 3 and IM 10%. Histopathological examination found red intact acid bacilli. Based on these findings we diagnosed him with multibasillary borderline lepromatous. We gave multy drugs therapy (MDT) for MB type for 12 months. But at 4 month follow up ENL reaction appeared thus. We managed him with continued MDT and prednisone 40 mg / 24 hours with tappered dose the ENL clinical improvement. The clinical feature of leprosy depends on the host response. Skin lesions can be hypoesthesia or anesthesia. The peripheral nerve is palpable and thick. Symmetrical anesthesia of the fingertips may also occur.