The increasing environmental degradation and the diversity of environmental issues affecting public health in Brazil have required changing the routines and norms of primary healthcare services. The aim of the current study was to explore the perceptions of family health strategy professionals about priority environmental issues associated with risks to the health of local communities. Participatory action research based on the photovoice and focal group techniques and conducted with 28 professionals from two family health strategies in the Casimiro de Abreu County, Rio de Janeiro State, Brazil.  Although participants were sensitive to health risk situations associated with inadequate environmental sanitation conditions, they showed limited perception about these risks and about possible actions to be taken in order to change local issues. Professionals of the two localities did not perceive themselves as co-responsible actors for improving the environmental conditions of the territory. There is need of taking contextualized environmental education actions focused on empowering and engaging health professionals, and the investigated community, to reduce health risk conditions through the equal access to sanitation services.

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