Seed system network analysis can reveal exchange connections between stakeholders and test scenarios such as those of seed systems shocks. We investigated the seed exchange network structure, disease surveillance risk, and gender contribution in Burundi, under two banana disease risk scenarios. Two sites where banana bunchy top disease (BBTD) is endemic in Cibitoke Province were compared with a site free of the disease in Gitega Province. All sites had formal seed interventions using community nurseries. A quantitative survey on seed sharing was done followed by a qualitative evaluation through focus group discussions. Banana seed sourcing options were fewer in the disease-free site, which also had higher cultivar diversity. Most farmers sourced seed informally within a three-kilometer radius. Seed sharing within and between villages was based on social and family linkages, especially for women. The interaction between the formal system and informal seed exchange was more active where new cultivars, or better seed quality was expected. The BBTD endemic region had lower seed quality assessment stringency. Farmers used both direct mother plant assessment and seed source reputation in seed evaluation. The formal banana seed systems are sources of new varieties, and trusted for clean seed but the informal system was still used as a main source of seed, especially local cultivars. Assessing disease surveillance scenarios shows women in a weaker position for healthy seed acquisition. Identifying the roles of individuals in seed systems can support decision processes for seed interventions in vegetatively propagated crops.