A young adult male, context , exhibiting a suite of proliferative and erosive skeletal changes, was excavated from the old burial ground of St Marylebone, London, in 2005 by the Museum of London Archaeology Service (MoLAS). Although pathognomonic rhinomaxillary changes were absent, a number of lesions were of a type previously recorded in individuals suffering from lepromatous leprosy, including resorption of the alveolar process of the maxillae and the digits of the right hand, osteomyelitis in the left ulna and collapse of the left ankle. Whilst this infectious disease was widespread in medieval Britain, it had declined by the 19th century, and has been identified in only one other post-medieval archaeological context. The right leg of  had been surgically amputated. This form of intervention was a recognised treatment for the complications of the disease, where neuropathic damage of limbs led to life-threatening infection. The healing of the amputation demonstrates the success of the operation, and the skill of the surgeon. Although the identity of the affected individual is unknown, burial within St Marylebone cemetery implies a level of status not frequently associated with leprosy sufferers in the past. Copyright © 2008 John Wiley & Sons, Ltd.