While production of high value vegetables are increasing worldwide, concerns on adverse health and environmental effects of pesticide use in agriculture are also increasing. The concern that farmers use excessive amounts of pesticides leading to health hazards to consumers and pollution of environment through accumulation of excess chemicals in soil and water bodies is common among environmental groups in Sri Lanka too. The objectives of this study were to study trends of pesticide use by vegetable farmers and to understand perceptions and attitudes of urban vegetable consumers on the impact of pesticide use on their health and their awareness on potential remedial measures. Data from seasonal reports of cost of cultivation of agricultural crops were used to analyze changes in pest and disease control practices by farmers. Trends of input use related to pest and disease control were studied using aggregate farm budgets. A primary survey was conducted among 150 semi-urban households to learn about attitudes and perceptions. Findings indicate that the percentage of farmers adopting pest and disease control methods has increased. However, contrary to the popular belief and findings of some studies of overuse of pesticides by farmers, this study reveals that the cost shares, real cost of material, used in pest and disease control in vegetables have declined over time. Consumers in the contrary believe that farmers use excess amounts of pesticides. A contingent valuation survey found that consumers are willing to pay premiums for higher quality vegetables. Although they like to consume pesticide-free vegetables their opinion is that the existing information is insufficient for them to differentiate vegetables during purchasing. The study proposes to develop appropriate extension and action research methods to closely work with farmers to understand and disseminate best practices on environmentally friendly methods of pest control.