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Leprosy is an endemic infectious disease caused by Hansen’s bacillus. It mainly affects the skin and nerves, but osteoarticular manifestations may also be observed, with varying prevalence worldwide. The osteoarticular manifestations of leprosy may be specific to the bacillus itself or secondary to immune reactions. Their pathophysiology is still not fully understood. They are polymorphous and under-explored, which makes their diagnosis particularly difficult and leads to therapeutic erraticity. The current therapeutic arsenal includes effective drugs and treatment plans for both leprosy and leprosy reactions. Early management is essential to avoid irreversible damage and functional impairment. This article provides a general review of the osteoarticular manifestations of leprosy and their management.