Background: Cutaneous leishmaniasis (CL) is a common cutaneous disease in the middle-east countries such as Iran. Khoozestan is an endemic area for it. The importance of this disease is in the formation of an ugly scar on the face, which damages beauty. There hasn’t been any effective topical treatment for this disease yet. Objective: To assess the effect of topical opium in the treatment of CL. Patients and Methods: A double blind, placebo controlled study was performed in Ahwaz during 1378 and 1379. 96 patients were included in this study and treated with a topical preparation of opium or placebo. The inclusion criteria for patient were: age more than 2 years, number of lesion less than 6, duration of disease less than 3 months, not using any drug with anti-leishmaniasis effect and positive direct smear. Pregnant or nursing patients were excluded. Results: From 58 patients who completed the study, 34 patients were given topical opium, 5 (4.2%) of them got cured. From 24 patients who were given placebo, only 1 (4.2%) patient got cured. This study did not show a significant difference between response to drug and placebo (P=0.12, chi-square test). Conclusion: From this study suggested that high concentration of topical opium or combination of topical opium with other material to be carried out.