This research work assesses exposure and health risk of farmers using DDT during Khat production and farmer’s knowledge and perception towards the toxicity of pesticides sprayed on Khat. Personal interviews were completed with a random and purposive sample of 85 farmers, 5 health workers/officers/ and 5 agricultural workers /officers/. The observed study shows there is no any personal protective device (PPD) in the study area at all, most farmers in the study area have no access to technical information on proper use of pesticides. In this study, thus, assessment of possible health risks of using DDT and farmers’ perception towards toxicity of pesticides used on Khat was undertaken. Results of interviews and questionnaires showed that majority of farmers in Chiro Woreda use DDT and other unknown pesticides to grow their Khat and majority of them mix DDT and other pesticides, especially malathion. Most of the farmers are illiterate and could not read and understand instruction on pesticides packages. Most of the interviewed farmers are chewers of Khat and have more than 15 years experience in spraying pesticides on Khat. Local markets, pesticides imported through smuggling, local health and agricultural bureaus were seen to be sources of DDT and other pesticides used on Khat. Most of the farmers have misperception on the toxicity of pesticides used on Khat. The farmers that sprayed Khat have also developed new health symptoms that were not known before the start of using DDT and other pesticides. The main purposes why farmers use pesticides on Khat are to control Khat pests that hinder its normal growth. Farmers that produce Khat with more chemical pesticides, in particular, experience acute adverse effects on the digestive system such as stomach irritation, bulging of belly, loss of appetite, and chronic adverse health effects including mouth dryness, headaches, and other related problems. Farmers also who chew homemade Khat on which they sprayed chemical pesticides by themselves may have the highest possible health hazards. It is concluded that chewing Khat grown with chemical pesticides causes considerable adverse health effects in human beings as well as to consuming animals. However, majority of the farmers believe that advantages of using DDT and other pesticides on Khat overweighed its effects. In general, there is no any satisfactory intervention to tackle these problems. The main objective of this study was to investigate exposure and possible health risks of farmers using DDT and other pesticides on Khat (Catha edulis), and to assesses the knowledge, perception and awareness of farmers towards toxicity of pesticides used during Khat production.