Foot and mouth disease (FMD) is the most economically important disease of livestock that still affects extensive areas of the world. This study described the use of participatory appraisal tools such as pair-wise ranking, matrix scoring and proportional piling to assess the perception of livestock keepers about the clinical signs and epidemiological features of cattle diseases with particular emphasis on FMD. Strong agreement among informant groups (W = 0.710; P = 0.000) in pair wise ranking indicated that the diseases were common problem to all the selected districts. Matrix scoring of disease indicators/signs also showed strong agreement (W = 0.504 to 0.955; P = 0.000) that implied significant current veterinary knowledge by Afar pastoralists. Age specific means of annual incidence rates estimated by proportional piling were significantly (P < 0.05) different but negatively correlated for FMD, CBPP and pasteurellosis. However, correlation was not significant for anthrax, blackleg and other important diseases. Age specific means of annual mortality was significantly (P < 0.05) but negatively correlated for FMD, CBPP, pasteurellosis and other important cattle diseases with correlation coefficients of -0.72, -0.81, -0.8 and -0.55, respectively. However, correlation (r = 0.12) was not significant for anthrax and not correlated at all for blackleg. This study indicated that pastoralists have detailed knowledge about their livestock health problems, and hence the combined use of participatory appraisal and conventional methods is essential for an ultimate disease control strategy.