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Background and Objectives: one of the endemic foci for Cutaneous Leishmaniasis in Iran is Mashhad in which limited outbreak have recently been reported. The commonly used method for diagnosis is the clinical features confirmed by direct microspic examination and culture or biopsy. We compared these two tests to determine the level of their sensitivity, specificity and positive predictive value. Material and Methods: we performed this comparative-analytic study on 73 patients suspected of having ulcers Leishmaniasis in Mashhad, Iran. Giemsa was staining the smears and the samples cultivated on Di-phasic NNN culture media. Analysis was performed by SPSS version 11.5 and Chi square test. A P-value less than 0.05 were considered as a significant. Results: In 43 cases (58.9%), both the smear and culture are Positive. In 13 cases (17.8%), the smear is negative but the culture Positive. In 17 cases (23.2 …