Background <p>Cutaneous Leishmaniasis (CL), the most prevalent type of Leishmaniasis, is a significant public health problem in various regions of the world including Pakistan, resulting in huge morbidity and social stigmatization.</p> Methods <p>This retrospective study was carried out mainly in three districts: Bajaur, Malakand and Dir Lower of Khyber Pakhtunkhwa (KP), Pakistan. Additionally, some cases from other districts were also recorded. Patients of different localities and age groups visiting healthcare centers including District Headquarters Hospitals in Dargai, Malakand and Bajaur were included in the study, with the approval from District Health Officer (DHO) of concerned districts.</p> Results <p>In total, 2035 cases of CL were recorded during the study period from January 2022 to February 2023. Statistical analysis revealed that the disease predominantly affected patients under 20 years of age (<i>n</i> = 1259, 61.9%), particularly males (<i>n</i> = 1067, 52.5%). The proportion of facial lesions was predominant (<i>n</i> = 1145, 56.3%), followed by lesions on the upper extremities (<i>n</i> = 317, 15.6%) and lower extremities (<i>n</i> = 338, 16.6%). Our findings indicate a high prevalence of CL in district Bajaur (<i>n</i> = 1222, 60.04%), followed by Malakand (<i>n</i> = 587, 28.84%) and Dir Lower (<i>n</i> = 153, 7.52%). Peak cases were recorded during summer and spring whereas autumn and winter showed a relatively lower incidence of CL, likely due to harsh environmental conditions that reduce the survival of sandflies.</p>