Introduction: Leishmaniasis is a contagious disease endemic in Brazil, transmitted by a vector, and its installation and form of presentation depend on the immunological status, location, and type of transmitted protozoan. Objective: A case report of a patient with localized American tegumentary leishmaniasis. Method: Reviews of medical records, analysis of photographic records of diagnostic tests and the evolution of the treatment to which the patient was submitted and literature review were carried out. Case Report: An 85-year-old woman, with a history of a single lesion on the 4 cm right forearm, with raised borders, ulcerated and clean bottom, subcutaneous edema, local pain and heat, pruritus, bloody secretion in small amounts, and no systemic symptoms. The same did not show improvement with the use of ointments (dexamethasone, neomycin, ketoconazole) and lasted for 2 months. The diagnosis of leishmaniasis was confirmed and treatment with intralesional meglumine antimoniate was carried out, with the application of 3 injections with an interval of 15 days. Final considerations: The case reported and the studies surveyed reveal the importance of the new treatment route and show that, although the approach requires specific conditions, such as being a single lesion, it courses with fewer adverse effects, lower cost, and greater safety.