By using a questionnaire survey and performing a case study in the Yushu Tibetan Autonomous Prefecture, this study examined the similarities and differences between the perceptions of local practitioners and the perceptions of experts regarding the priority of the factors affecting earthquake emergency response and rescue at the county level in China. The results show that the perceptions of the most and the least important factors are similar between the two groups, except for the factors that affect special abilities. However, one first-level factor, i.e., environmental conditions, and 16 second-level factors, e.g., influence of ethnic cultures, professional rescue teams, GDP level and historical earthquake disaster experience, significantly differed. The local realities of the natural geography, socioeconomic conditions (e.g., economic level, education and ethnic), earthquake experiences and knowledge form the perception of local practitioners, whereas the experts' perceptions are more consistent with their social role, emergency experiences and knowledge, especially in disaster-prone areas, influencing the differences between the two groups. Suggestions regarding the incorporation local perceptions into the development of local emergency capabilities rather than merely following the perception of experts are discussed.