Introduction: Leprosy or Hansens disease is caused by Mycobacterium Leprae. It is a chronic granulomatous and infectious disease primarily affecting the skin and peripheral nerves. Case detection rates are still high indicating active transmission. This study was conducted to analyze the trends in leprosy over a period of five year in a tertiary care hospital, Central India. Methods and Materials: Slit skin smear were taken as per standard protocol from patients attending outpatient Department of Dermatology (Venerology and leprosy) from a tertiary care hospital in Central India. Medical records of clinically diagnosed Hansens patients were collected retrospectively between January 2018 to December 2022. Results: A total 2166 cases of slit skin smear positive for acid fast bacilli was seen in 37.30%. A slow but steady rise in leprosy cases has been noted. In the year 2022, there were maximum number of new cases detected which were 244 accounting for 48.03%. Males 492 (60.89%) outnumbered females 316 (39.11%). The majority of the participants 486 (60.15%) were between the ages of 21 to 40. Maximum number of cases 669 (82.79%) found to have bacteriological index between 1+ to 3+. Of newly diagnosed leprosy cases, 378 (46.79%), had MI between 1 to 25. Multibacillary patients constituted 436 (53.96%) while 372 (46.03%) were paucibacillary patients. Conclusion: The leprosy programs have brought down the cases but pockets of active transmission exist in some areas. Early case detection, early institutional visit, enhancing active health education and interventions for leprosy are forwarded to eliminate disease. Detection of high number of cases signifies increased burden of Hansens diseases in this area even in the post elimination era.