Leptospirosis is a neglected bacterial zoonosis that disproportionately affects people exposed to contaminated water, soil, rodents, livestock, and flood environments. Rural residents in endemic regions often understand that the disease is serious, yet preventive recommendations may conflict with livelihood demands, limited household resources, inadequate drainage and waste services, and deeply established social practices. This evidence-informed narrative article examines community-perceived barriers and facilitators to leptospirosis prevention, drawing on qualitative studies, community surveys, epidemiological research, and authoritative guidance. Recurrent barriers include incomplete or misleading knowledge, low perceived personal susceptibility, normalization of occupational exposure, discomfort and cost of protective equipment, dependence on paddy farming and animal care, poor sanitation, rodent infestation, delayed recognition of symptoms, and limited trust in episodic health campaigns. Knowledge alone does not reliably produce protective behaviour when structural conditions make exposure unavoidable. Facilitators include trusted communication through local health workers and community leaders, practical demonstrations, affordable and climate-appropriate protective equipment, reliable water and sanitation, coordinated rodent and waste control, early-care pathways, seasonal alerts, and community participation in locally designed interventions. Effective programmes should combine individual protection with environmental improvement and One Health coordination across human health, veterinary, agriculture, sanitation, and disaster-management sectors. Prevention messages must be specific, feasible, non-stigmatizing, and timed before monsoon, flooding, and peak agricultural activity. Community members should be treated as partners who possess essential knowledge of local exposure routes and workable solutions. A sustained, participatory approach can narrow the gap between awareness and practice and improve timely prevention and care in rural endemic settings.

Keywords: leptospirosis; rural communities; prevention; barriers; facilitators; risk perception; One Health; health education