Hansen disease, commonly known as leprosy, is uncommon in the United States and poses difficult diagnostic and treatment challenges. A 10-year-old girl was adopted from Ethiopia with a history of "multibacillary leprosy" and "multidrug treatment" for 12 months. Three months after her arrival in the United States and 4 months after treatment was completed, she presented with new papules and plaques on her left nose and ear. Herein, we present her case and review current treatment options in leprosy in children and the management of immunologic reactions.