This Position Piece examines the nature of Vietnamese folk constructions of leprosy through Mary Douglas’s (1969) and Victor Turner’s (1967) works. Investigating Vietnamese explanations for the origins of leprosy and its channels of transmissions, symptoms, and consequences, I argue that these accounts are rooted in narratives of transition, transgression, the crossing of boundaries, and categorical confusion of various kinds. I argue that these deeply embedded perceptions of leprosy help to explain the existence of persistent stigma against leprosy in Vietnam, despite highly effective drug treatments and extensive state awareness programmes.