A new, large randomised controlled trial of giving a single dose of rifampicin to close contacts of newly diagnosed leprosy patients was about 57% efficacious in reducing new cases of leprosy but only for the first 2 years of follow-up. The Enhanced Global Strategy for Leprosy has recommended the exploration of the use of chemoprophylaxis as a tool to prevent the occurrence of new leprosy cases among household contacts as a result of this finding. Pilot projects on implementing chemoprophylaxis under routine programme conditions are recommended to assess acceptability, cost-effectiveness, feasibility, and ethic issues.