OBJECTIVE: To present otorhinolaryngologic alterations in the context of a specific case of leprosy. CASE REPORT: We present a case of lepromatous leprosy with Lucio's phenomenon-associated evidence of otorhinolaryngologic alterations in the nose, ear, and larynx consistent with the diagnosis. The main patient complaints were related to the skin lesions and the associated pulmonary symptoms. However, in the chronology of the case, the otorhinolaryngologic findings preceded the evidence that would come to define the diagnosis, such as skin lesions and laboratory tests (bacilloscopy and an evaluation of acid-alcohol-resistant bacilli in the lymph). CONCLUSION: From the evidence found, we note the importance of the observation of otorhinolaryngologic changes in the evaluation of leprosy cases.