This study reports the knowledge and beliefs about filarial elephantiasis and hydrocele of people from an endemic area of Orissa, India. Both qualitative and quantitative data were collected from 12 villages, sampled from four blocks in the Khurda district of Orissa. This study found that people were aware of different manifestations of filariasis, and perceived them as problems in their community. A high proportion of people knew that mosquitoes are the reason for the spread of elephantiasis, but less people were aware of the cause of hydrocele and the association between elephantiasis and hydrocele. Only half of the respondents believed that elephantiasis is curable by modern medicines, and about 84% of respondents thought that surgery is the only method to cure hydrocele. About two-thirds of people know that avoiding mosquitoes can prevent elephantiasis. Age, gender, educational level and caste affiliation were identified as factors influencing awareness and knowledge. These findings may be used in the development of group-specific health education programmes to change health behaviour and to achieve higher involvement of the community in annual mass drug administration to eliminate lymphatic filariasis.