New Caledonia (NC) is a French overseas collectivity in the Asia-Pacific region where leprosy is still present. Epidemiological surveillance of cases reported from 1983 to 2017 recorded 342 cases. Since 1988, the overall annual prevalence has been less than 1 per 10,000 inhabitants, the endemicity threshold set by the World Health Organization. Nevertheless, the study reveals an area of superendemicity on the island of Belep (site of the first leprosarium), where the average annual detection rate from 2007 to 2017 was 126.5 per 100,000 inhabitants. Over the past 10 years, the predominance of multibacillary forms and the discovery of new pediatric leprosy cases demonstrate the persistence of transmission in the Northern Comoros. Following this study, public health measures and in-depth studies have been implemented.