Öz Multibacillary, lepromatous or borderline leprosy patients may present two types Vasculonecrotic reactions: Erythema Nodosum Leprosum (ENL) with vasculitis and Lucio Phenomenon. ENL is Type 2 Lepra Reaction while Lucio Phenomenon commonly seen in nonnodular diffuse leprosy patients, mainly reported from Mexico. Here we reported a case of 20 year old male, RFT (Relief From Treatment) leprosy patient presented with fever, malaise, joint pain, edema over hands and feet and red tender elevated nodules. Interestingly, within 3 days of admission he developed multiple vesicular erythema multiforme like eruption on chest, back and upper extremity, which broken down to form necrotic ulcer in following 4 days. Biopsy showed leucocytoclastic vasculitis and fibrin deposition in vessel walls. Furthermore, USG of both ulnar nerves showed thickening. These clinical and histopathological features helped us to arrive at the diagnosis of the ENL with vasculonecrotic phenomenon. J Microbiol Infect Dis 2019; 9(3):133-136.