Multibacillary leprosy (MB) is a chronic infectious disease with significant physical and socioeconomic ramifications.  Despite the availability of free multi-drug therapy (MDT), patient dropout rates remain a substantial concern.  Socioeconomic factors such as stigma, discrimination, financial constraints, and limited healthcare access frequently contribute to treatment non-compliance, resulting in disease progression and increased disability risk. Case: A 58-year-old male presented to the dermatology and venereology clinic following discontinuation of leprosy treatment.  He had been diagnosed with multibacillary leprosy (MB) one year prior and initiated multi-drug therapy (MDT), but ceased treatment after two months due to financial constraints, the twenty kilometer commute from his residence to the hospital, and extended wait times for BPJS services, which conflicted with his employment as a local bus driver.  Several months post-discontinuation, he experienced a minor motor vehicle accident attributed to progressive paresthesia in his hands, resulting in subsequent job loss. The patient, along with his wife, attempted to establish a chicken noodle shop. However, the venture failed within four months due to insufficient patronage.  Community stigma associated with the patient's leprosy, specifically the visible lesions on his fingertips, resulted in customer reluctance.  He also experiences social ostracism at village gatherings, leading to significant psychological distress. Feelings of inadequacy as a family provider, and mood instability.  His two children are currently enrolled in the third and first grades of high school, respectively, and receive government educational support.  The family's daily necessities are met through social welfare programs. The patient is currently unemployed but engages in occasional construction work. Discussion: This case underscores the multifaceted burden of leprosy, encompassing not only its medical consequences but also significant socioeconomic factors that can compromise treatment efficacy.  The pervasive social stigma and challenging economic circumstances frequently contribute to patient treatment non-adherence and subsequent clinical decline.  A comprehensive, multidisciplinary strategy incorporating community health education, socioeconomic empowerment initiatives, and equitable healthcare policies is essential to enhance treatment adherence and improve patient outcomes. Conclusions: Treatment discontinuation among multibacillary leprosy patients is frequently attributable to underlying socioeconomic factors, significantly impacting their quality of life. Consequently, a comprehensive approach is required to mitigate stigma, enhance access to healthcare, and bolster social and economic support for these leprosy patients.