Introduction: The aim of this study was quantify annexin A1 expression in macrophages and cluster of differentiation 4 (CD4)+ and cluster of differentiation 8 (CD8)+ T cells from the skin of patients with cutaneous leishmaniasis (n=55) and correlate with histopathological aspects. Methods: Infecting species were identifi ed by polymerase chain reaction-restriction fragment length polymorphism, and expression of annexin A1 was analyzed by immunofl uorescence. Results: All patients (n = 55) were infected with Leishmania braziliensis. Annexin A1 was expressed more abundantly in CD163+ macrophages in infected skin (p < 0.0001) than in uninfected skin. In addition, macrophages in necrotic exudative reaction lesions expressed annexin A1 at higher levels than those observed in granulomatous (p < 0.01) and cellular lesions p < 0.05). This difference might be due to the need to clear both parasites and necrotic tissue from necrotic lesions. CD4+ cells in cellular lesions expressed annexin A1 more abundantly than did those in necrotic (p < 0.05) and granulomatous lesions (p < 0.01). Expression in CD8+ T cells followed the same trend. These differences might be due to the pervasiveness of lymphohistiocytic and plasmacytic infi ltrate in cellular lesions. Conclusions: Annexin A1 is differentially expressed in CD163+ macrophages and T cells depending on the histopathological features of Leishmania-infected skin, which might affect cell activation.