The extensive use and misuse of antibiotics in the livestock sector is one of the main drivers of the emergence and spread of antimicrobial resistance. Although small-scale farms constitute most of the livestock production in low and middle-income countries, knowledge and use of antibiotics among these populations is sparse. We conducted 201 questionnaires to estimate the use and knowledge of antibiotics by small-scale farmers located in the coastal area of the Lima region of Peru. Our results show that farmers had a small number of livestock (e.g. average of 11 cows, 7 pigs and 19 chickens per farm) and 80 % earned less than minimum wage. More than half of farmers reported at least one episode of respiratory disease, diarrhea, mastitis, skin lesion or post-parturition infection in their animals during the previous year, and 40 % of these episodes were treated with antibiotics. Farmers r...