OBJECTIVE: This study was designed to determine the epidemiological and clinical characteristics of cutaneous leishmaniasis among patients attending at Tefera Hailu Memorial Hospital, Sekota, Northeast Ethiopia over the last 5 years. METHODS: A 5-year retrospective study was conducted at Tefera Hailu Memorial Hospital, Northeast Ethiopia. Data were summarized and analysed using Microsoft Excel and SPSS 26 version software, respectively. To present the data and evaluate the patterns in cutaneous leishmaniasis cases across the 5 years, months, and seasons, descriptive statistics were utilized. In multivariable logistic regression analysis of determinants in relation to cutaneous leishmaniasis positivity, -value less than 0.05 was considered as statistically significant. RESULT: The overall positivity rate of cutaneous leishmaniasis was 31.1% (452 out of 1455) over the last 5 years at Tefera Hailu Memorial Hospital. The result showed a fluctuating yet declining trend in cutaneous leishmaniasis infections. The highest number of cases was registered in 2016, while the lowest was in 2020. Males and the age group of 15-49 years, accounted 78.5% and 79.9% of the patients, respectively, were the hardest hit by cutaneous leishmaniasis in the area. Similarly, the highest number of cases was observed in Dehana district (268). From all registered confirmed cases, 54 (10.7%) were previously treated cases. Moreover, the majority of cases, 423 (93.6%) were localized cutaneous leishmaniasis and most of the lesions were on the face. CONCLUSION: Although the results indicate a fluctuating yet declining trend, the positivity rate of confirmed cutaneous leishmaniasis cases in the area remains alarming and indicates a major public health burden. Therefore, efforts are required to reduce the disease burden through continuous monitoring and evaluation of control measures in the study area.