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Background Following introduction of antimycobacterial treatment of Buruli ulcer disease (BUD), several clinical studies evaluated treatment outcomes of BUD patients, in particular healing times, secondary lesions and functional limitations. Whereas recurrences were rarely observed, paradoxical reactions and functional limitations frequently occurred. Although systematic BUD control in Togo was established as early as 2007, treatment outcome has not been reviewed to date. Therefore, a pilot project on post-treatment follow-up of BUD patients in Togo aimed to evaluate treatment outcomes and to provide recommendations for optimization of treatment success. Methodology/Principal Findings Out of 199 laboratory confirmed BUD patients, 129 could be enrolled in the study. The lesions of 109 patients (84.5%) were completely healed without any complications, 5 patients (3.9%) had secondary lesions and 15 patients (11.6%) had functional limitations. Edema, category III ulcers >15cm, healing times >180 days and a limitation of movement at time of discharge constituted the main risk factors significantly associated with BUD related functional limitations (P180 days and limitation of movement at discharge constituted the main risk factors for functional limitations in Togolese BUD patients. Standardized treatment plans, patient assessment and follow-up, as well as improved management of medical records are recommended to allow for intensified monitoring of disease progression and healing process, to facilitate implementation of therapeutic measures and to optimize treatment success., Author Summary Buruli ulcer disease (BUD) is a mycobacterial skin disease which leads to large ulcerations and causes disabilities in approximately 25% of the patients. Treatment consists of antimycobacterial drugs, complemented by surgery and physiotherapy if necessary. Available data on treatment outcome of BUD patients suggest that recurrences are rare; paradoxical reactions and functional limitations, however, frequently occur. BUD control in Togo was introduced already in 2007, but treatment outcome has not yet been reviewed. Therefore, a clinical follow-up study assessed a cohort of 129 BUD patients at least six months after the end of treatment. The lesions of 84.5% of the patients were healed without complications, 3.9% had secondary lesions, and 11.6%, a lower proportion than in other studies, had functional limitations. Hereby, edema, category III ulcers, healing times >180 days, and limitation of movement at discharge constituted the main risk factors. Review of all BUD related documentation revealed a number of shortcomings, in particular concerning medical records. In view of these findings, standardization of procedures for creating of therapy plans, patient assessment and follow-up, as well as improved management of medical records are recommended to facilitate implementation of therapeutic measures to optimize treatment outcome and to allow for further evaluation.