NLR has been actively engaged in leprosy treatment and elimination initiatives for over four decades, collaborating closely with the government, the Ministry of Health and Population, and other relevant stakeholders. From 2005 onwards, NLR broadened its mandate to include disability-inclusive development and inclusive development, primarily focusing on health, the environment, and human rights perspectives. Between 2012 and 2017, NLR employed innovative approaches aimed at transforming certain municipalities into Model Villages.

In 2018, the NLR in Nepal transformed into a national organisation with a vision of achieving health and empowerment for all. NLR Nepal has been registered as a not-for-profit national organisation under the Company Registration Act of Nepal.

NLR Nepal is a member of the NLR Alliance, led by NLR International in the Netherlands. The other members of the NLR Alliance include NLR India, NLR Indonesia, NLR Brazil, and NLR Mozambique. NLR Netherlands serves as the lead/chair of the NLR Alliance, responsible for overall coordination and providing technical and financial support to leprosy and disability programs in member countries, including Nepal.

NLR Nepal collaborates closely with the government, non-governmental stakeholders, and partners to end leprosy in Nepal and ensure that all development initiatives include individuals affected by leprosy, disabilities, and marginalisation due to various circumstances. NLR Nepal is headquartered at Sankhamul Marga, New Baneshwor, Kathmandu, with field offices in Biratnagar and Dhangadhi. It spans two provinces: Province Koshi and Sudur Pashchim Pradesh. NLR Nepal provides ongoing support to several districts and municipalities nationwide, primarily focused on leprosy and disability-related activities.

NLR Nepal has signed the eighth project agreement (2016-2020) with the Social Welfare Council and is currently contributing support to Leprosy Control, Disabilities Management & Inclusion in Nepal.