Past studies highlight harmful effects of using pesticides and untreated wastewater on farmers’ health in agriculture. However, none of the studies explore these sources to determine the magnitude of deleterious health effects simultaneously. Vegetable growers in peri-urban areas of developing countries are facing severe problems of acute symptoms, not only because of intensive use of hazardous pesticides but also due to irrigation with untreated wastewater. The objective of this article is to quantify pesticide and untreated wastewater induced health symptoms among vegetable growers. A sample of 830 vegetable growers was selected by stratified random sampling from three major vegetable growing districts of Pakistan’s Punjab. A two stage estimation technique was employed to estimate unbiased health effects of vegetable growers after controlling for the endogeneity of pesticide use. The results demonstrate that both untreated wastewater and pesticide quantities are responsible for acute symptoms but comparison of their coefficients indicates that one litre of pesticide quantity is causing 3 times more symptoms than one hour of untreated wastewater use. Therefore, in order to minimize these negative health effects, the policy makers in under developing countries need to focus more on the reduction of hazardous pesticide use than untreated wastewater. Although, untreated wastewater is also significantly responsible of acute symptoms and therefore, it should not be ignored.