Surveys of smallholder farmer knowledge, attitude, practice (KAP) and income were conducted in 2011 and 2012 in five northern provinces of Lao People’s Democratic Republic (Lao PDR; n?=?200 farmers). Participating villages were classified as either from a livelihood development project (LV; n?=?80 farmers) or a livestock research project that contained both ‘high-intervention’ (HI; n?=?60 farmers) or ‘low-intervention’ (LI; n?=?60 farmers) villages. Farmer training plus a suite of health and productivity interventions were implemented in HI sites; only vaccination was implemented in LI sites, whilst various interventions and limited vaccination were introduced to LV sites. Farmer interviews were conducted with survey questions on socioeconomic variables and KAP of large ruminant health and disease risk management, enabling determination of quantitative and dichotomous qualitative traits and comparison of results from HI, LI and LV villages. The average farmer income from sales of large ruminants in HI was USD 621, in LI was USD 547 and in LV was USD 225 (p?0.001). The predicted mean of total knowledge scores (/42) in the 2012 survey in HI was 28, in LI was 22 and in LV was 17 (p?0.001). We conclude that improved KAP of large ruminant health and production can be achieved by intensive training, although with some farmers yet to apply their knowledge on husbandry and biosecurity practices, continued learning support and closed linkage of research and development projects to improve extension capacity is recommended. This multiple participatory approach promoting biosecurity in addition to vaccination may provide a more sustainable pathway for the advancement of Lao PDR on the Progressive Control Pathway for foot and mouth disease control.