Foot and mouth disease (FMD) is a highly contagious viral disease affecting livestock, caused by the Foot and Mouth Disease Virus (FMDV). The North African region is vulnerable to transboundary diseases, and the livestock population at risk is substantial. The genetic diversity of FMDV in the region poses challenges for control measures, as vaccination or recovery from one serotype does not guarantee protection against others. The risk of disease introduction through illegal animal movement is leading North African countries to follow strict WOAH sanitary measures and animal movement controls. Algeria has faced multiple outbreaks, some linked to the illegal movement of animals across borders. Tunisia experienced outbreaks in 2014 and 2017, with genomic analysis indicating connections to West African countries. Libya encountered historical FMDV incursions, and despite control efforts, illegal animal movement and inadequate facilities posed challenges. Morocco reported outbreaks in 1991 and later in 2015, introducing vaccination strategies. Egypt’s FMD history showed multiple serotypes causing outbreaks. Control strategies include vaccination, compensation for affected farmers, and control measures such as disease notification, surveillance, and movement restrictions. The compensation rates for farmers vary depending on factors such as animal type and the approved compensation approach. In conclusion, the complexity of FMD control in North Africa, highlights the need for regional collaboration, effective control measures, and ongoing vigilance to mitigate the economic and health impacts of the disease.