A taxonomic revision of the genus Lepisanthes Blume in Madagascar is presented. Three species are recognized based on an analysis of morphological characters in combination with eco-geographic parameters. Two infraspecific taxa recognized previously in Aphania senegalensis (Juss. ex Poir.) Radlk. (= Lepisanthes senegalensis (Juss. ex Poir.) Leenh.) are raised to the species level, viz. L. chrysotricha (Capuron) Buerki, Callm. & Lowry and L. perrieri (Capuron) Buerki, Callm. & Lowry. A third species from northwestern Madagascar is described as new, L. sambiranensis Buerki, Callm. & Lowry. An identification key to the Malagasy species of Lepisanthes is presented as well as preliminary assessments of the conservation status for each species.