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Abstract Leprosaria established in the Americas during the Colonial period bear many similarities with those found in medieval Europe. They are comparable in terms of isolation, the objectification of leprosy sufferers and their association with religious charities. The Lazaretto on St Eustatius was operated from 1866 to 1923. The site was investigated to recover palaeopathological evidence of leprosy at a leprosarium in the Americas. Five burials were excavated; three individuals showed evidence of bone modifications consistent with those caused by leprosy, including aspects of ‘rhinomaxillary syndrome’ and the bilaterally symmetrical post‐cranial changes that have been described in leprosy examples from medieval Europe. An exceptional find was the presence of potentially leprous bone changes to the hyoid, thyroid and 3rd–6th cervical vertebrae. Copyright © 2007 John Wiley & Sons, Ltd.
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