BACKGROUND: Skin problems are the commonest reason for people accessing healthcare services in Nepal but there is little information about the prevalence of skin disease. OBJECTIVES: To perform a point prevalence study of skin disease in the Terai region of Nepal. METHODS: Five villages were randomly selected in Bara District in the Terai region of Nepal, and 878 people were examined. RESULTS: The number of individuals identified as having a skin disease was 546. The point prevalence of identifiable skin abnormalities was 62.2% (546 of 878) (with 95% exact confidence intervals 58.9-65.4%). A wide range of dermatoses was identified. The six most prevalent were dermatophyte infections (11.4%), followed by pityriasis versicolor (8.9%), acne (7.7%), melasma (6.8%), eczema (5.6%) and pityriasis alba (5.2%). Overall, treatable skin infections and infestations were by far the commonest skin diseases identified. CONCLUSIONS: Our study has demonstrated a very high point prevalence (62.2%) of skin disease in rural Nepal. This study represents the first formal survey of skin disease in Nepal and demonstrates a large burden of disease, in particular treatable infections.