Objectives: The purpose of this research is to analyze the efficacy of antibiotic (rifampicin) in a randomized double-blind and placebo-controlled assessment to treat cutaneous leishmaniasis. Patients and methods: This study is to evaluate the success of oral antibiotic (rifampicin) in a dose of 10mg per kilogram daily that giving orally for 4 weeks, in a cutaneous leishmaniasis in a confirmed cases either by smear or biopsy. The study was conducted from January 2019 through January 2020 at the Department of Dermatology, Prince Mishari Ben Saud Hospital, Baljurashi (Baha region), Saudi Arabia. 53 patients with single or multiple cutaneous leishmaniasis lesions were studied, of which 35 patients were choose for drug administration and 18 patients for control. Results: Of 53 patients receiving rifampicin, a total of 35 were assigned, and 18 for control. Follow-up data for 32 (91.4 percent) and 16 (83.3 percent) patients were available, respectively. After twelve weeks' follow-up, 32 out of 35 rifampicin group patients (91.4 percent) and 16 out of 18 placebo group patients (88.9 percent) had complete the full course. Healing rates in the rifampicin and control community were 93.8 percent and 18.8 percent, respectively, according to purpose to treat leishmania in this research. Conclusion: Orally administered of rifampicin weekly for one month can be an alternative to other injectable medications. It is easy to use, very effective, and cheap drug for the treatment of cutaneous leishmaniasis. For children where other traditional injectable therapies are not appropriate, practical or may be dangerous, the findings were more promising.