Objective The objective of this study was to examine the potential relationship between leukocytoclastic vasculitis (LCV), a small-vessel vasculitis, and neuropathy. While LCV primarily affects the skin, its systemic involvement, including the development of neuropathy, has been increasingly recognized. This study aimed to assess whether LCV patients have a higher risk of developing neuropathy compared to a demographically matched control group. Materials and methods This retrospective cohort study utilized data from the TriNetX database (TriNetX, LLC, Cambridge, Massachusetts, USA). A total of 4,519 patients diagnosed with LCV were matched with 4,519 control patients based on demographic factors such as age, sex, and race to ensure comparable baseline characteristics between groups. Neuropathy in both groups was identified using the ICD-10-CM diagnostic code G62.9. Statistical analysis was performed to evaluate the relative risk of neuropathy in LCV patients compared to the control group. Results The analysis revealed that 5.4% of LCV patients were diagnosed with neuropathy, while 4.6% of the control group were affected. This difference was statistically significant, with a relative risk (RR) of 1.209, indicating that LCV patients have a 20.9% higher risk of developing neuropathy than controls (95% confidence interval (CI): 1.009-1.448, p = 0.0396). These findings suggest that LCV may contribute to the development of neuropathy. Conclusion This study provides evidence supporting the association between LCV and an increased risk of neuropathy. The findings highlight the potential for systemic neurological complications in patients with LCV, which may be attributed to vasculitic damage to the nerve blood supply. Despite the challenges in diagnosing LCV-associated neuropathy, the study underscores the importance of vigilant monitoring for neurological symptoms in LCV patients.