This study describes antibiotic use by small-scale freshwater aquaculture farmers in the upper Mekong Delta in southwestern Vietnam and the knowledge and practices surrounding the cause and prevention of aquaculture disease in that region. Forty five farmers were included in the study, of which 19 (42%) cultivated tilapia Oreochromis spp., 13 (29%) Striped Catfish Pangasianodon hypophthalmus and 13 (29%) giant river prawns Macrobrachium rosenbergii. Antibiotics were used by farmers of tilapia and Striped Catfish (84% and 69% of farmers, respectively), but not by any of the prawn farmers. Most farmers (72%) used antibiotics for around 3 d when treating diseases, depending on the farmers' economic means and whether the fish recovered, as judged by the farmer. If farmers perceived that the