Cutaneous leishmaniasis remains endemic in several rural areas of Costa Rica, disproportionately affecting Ngäbe-Buglé indigenous children. Environmental exposure to sandfly vectors, mobility across forested zones, and housing conditions increase infection risk. Limited access to healthcare and delayed diagnostic opportunities often prolong disease evolution. During a clinical rotation in San Vito de Coto Brus, several Ngäbe-Buglé children presented with cutaneous lesions compatible with leishmaniasis. These cases, supported by photographic documentation, illustrate the ongoing burden of this neglected tropical disease in structurally vulnerable communities.This visual case series draws on clinical encounters from primary care visits and community outreach in Ngäbe-Buglé settlements near San Vito. Data collection focused on physical examination and photographic documentation of lesion characteristics, including morphology, size, and anatomic distribution. Contextual variables such as exposure patterns, living environment, and access to care were also recorded to complement the visual assessment.Visual documentation of cutaneous leishmaniasis in Ngäbe-Buglé children is rarely available, despite the community’s high exposure and structural vulnerability. By integrating clinical photography with field-based observations, this poster offers a clear and educational representation of lesion patterns encountered in a real rural setting. The combination of dermatologic images and contextual information highlights how environmental and social factors shape presentation, recognition, and access to care in indigenous pediatric populations.The cases highlight the importance of visual recognition for early diagnosis in resource-limited settings. Strengthening local diagnostic capacity, ensuring consistent availability of antileishmanial treatment, and reinforcing culturally adapted community outreach may reduce delays and prevent complications. Future strategies should incorporate telemedicine support and collaboration with indigenous leaders to promote sustainable public health interventions.The photographic cases reveal how environmental exposure, socioeconomic barriers, and long travel distances to healthcare centers contribute to advanced or persistent presentations. Visual documentation underscores classic ulcerative lesions and reinforces the role of frontline primary care in early recognition, even when laboratory confirmation is limited. Addressing structural inequities remains essential to improving outcomes.Cutaneous leishmaniasis continues to reflect structural vulnerability among Ngäbe-Buglé children in southern Costa Rica. Visual case documentation from primary care provides a powerful tool for clinical education, advocacy, and the development of territory-sensitive health strategies.