A cross-sectional study conducted in Al-Madinah Almonawarah in KSA held during the period from March 2014-March 2015. This study aiming to identify the epidemiological and clinical pattern of cutaneous leishmaniasis in Al-Madinah Almonawarah area. Epidemiological and clinical data were collected using special questionnaire. Statistical analysis was done using special computer program SPSS. Laboratory specimens were collected using skin scraping and needle aspiration. Staining and direct microscopy were done. LST was conducted. The study includes 164 patients, all of them were men, almost half of them were farmers. 58% indoor transmission. Bed nets were not used by 85.4% of patients, moreover most of the patient 83% were not using protective clothes. Clinically sever form of presentation indicate 4 and more ulcers. Severe form was encountered in (14.6%) among children < 15years and 32.1%. in the Adults. Those with underweight had higher percent in mild and severe form of presentation 61.5% and 38.5% respectively. LST was negative in all cases. The study revealed that Al-Madinah Almonawarah is endemic area for cutaneous leishmaniasis due to the presence of the vector and the reservoir. Age has less effect on clinical presentation (indoors and outdoors transmission are present) compared with social habits of patients and nutritional status.