Background: Cutaneous leishmaniasis (CL) is a protozoan disease of the skin caused by a wide range of italic species. The disease is endemic in many countries. It has been recognized as a major public health problem in Iran. Many treatments have been suggested for it but none of them was fully effective. Objective: The objective of this study was to compare the efficacy of a 5% garlic cream with placebo in CL. Patients and Methods: A double blind, placebo controlled study was performed in Isfahan and Jahrom in 1997 and 1998. 197 patients were randomly selected. Exclusion criteria were: pregnancy, lactation, age less than 5 years and duration of disease more than 100 days. Each patient received garlic cream 5% or placebo for 3 weeks and was followed for another period of 40 days. Results: The study was completed as planned in 171 patients. 96 were treated with garlic 5% cream and 75 with placebo. Complete healing occurred in 18 (18.75%) of garlic group in comparison with 15 (20%) of placebo group. The difference was not significant (P=0.9865). Conclusion: 5% garlic cream was not effective in treatment of cutaneous leishmaniasis. Further studies with higher concentrations or different vehicle are needed.