The effectiveness of excision of pre-ulcerative Buruli lesions in field situations was assessed in a prospective study in an endemic focus in rural Ghana. All 50 patients, clinically diagnosed as having pre-ulcerative Buruli lesions, had their lesions excised followed by primary suturing. The patients were then followed up until the wound healed and thereafter for a year or until recurrence. The median duration for complete healing after excision was 31.5 days while the 1-year recurrence rate was 16%. None of the patients had any form of deformity after healing in contrast with the usual consequences of other forms of treatment. Our findings suggest that excision of pre-ulcerative Buruli lesions is effective in preventing deformities but less so for preventing recurrence of lesion.