Effects of pesticide exposure on public health are monitored in developed countries, which is rare in the least developed countries like Bangladesh. Here, a surveillance study was conducted to investigate the farmer's knowledge and perception toward pesticide use and the impact of occupational exposure as well as an environmental hazard in six agro-based districts (Gazipur, Khulna, Manikganj, Naogaon, Mymensingh and Tangail) in Bangladesh. A questionnaire was designed for a face to face interview of the farmers (at least 100 farmers in each district), and the data was collected. The farmer during cultivations used pesticides as single, double or several times in a single crop cycle. Among different types of pesticides, insecticides were highly used (38%), whereas Imidacloprid, and Lamda cyhalothrin insecticide was top used by the farmers. Weedicides or herbicide, fungicides and rodenticides were used 11%, 48%, and 0.5%, respectively. The knowledge and perception of the farmers towards pesticide usage are minimum, whereas the environmental pollution aspect is deficient. The knowledge of using personal protective equipment is the least. Eighty five percent of farmers use pesticides by spraying in the field. Thirty nine percent of farmers suffered from sneezing, burning sensation on face, conjunctivitis, dizziness and headache during pesticide application, and 3% suffered from skin rash of long time exposed with pesticide. The exposure of pesticides is widespread in the professional life of a farmer in Bangladesh. So, it is essential to ensure different training and awareness building program for the farmers to cope the adverse situation.