ABSTRACT. Leprosy reactions are complex immune events, generating disabling consequences and threatening the lives of those who experience them. This case report addresses the episode of a 28-year-old female patient who suffered a severe type-2 leprosy reaction, characterized by significant hepatic involvement, specifically, nonalcoholic hepatic steatosis. This case report underscores the importance of maintaining a high level of clinical suspicion, early recognition, accurate diagnosis, and immediate addressing of these types of reactions that may arise in the context of leprosy.