Objective To investigate local perceptions of the causes and prevention of the COVID-19 pandemic in Guji Society, West Guji Zone, Bule Hora district. Methods The researcher conducted a qualitative study using in-depth interviews and key informant interviews, focus group discussions, and case study with 46 informants, of which 22 were women and 24 were men. The informants were recruited using purposive sampling. The data was analyzed by qualitative description. Results The findings indicate the wrath of Waaqaa (God), evil spirit attacks, Gadaa party's omen, the virus, and unknown forces are thought to be the causes of the virus. The local amelioration and prevention mechanisms reported by the informants were rituals of praying for God's mercy and social distancing, along with using face-masks, keeping hygiene, and getting vaccines. Conclusion The local community's perceptions about the COVID-19 pandemic's causes and prevention methods are based on myths, assumptions, and belief systems that contradict medical science concepts and prevention methods. As a result, this scenario would result in potential risk factors like susceptibility to the virus, severe health complications, and psychological and socio-economic adverse impacts.