In this study, 130 small-scale farmers were surveyed regarding pesticide use patterns in rural Phitsanulok, northern Thailand using a structured questionnaire administered via personal interviews and an observational checklist of farmer pesticide storage practices. The survey was conducted during December 2007-January 2008. The results indicate pesticides are readily available and widely used in crop production. This includes the use of endosulfan which has been banned by the Thai government since 2004. Overall, pesticide use was inappropriate. Farmers did not wear suitable personal protection, apply pesticides in an appropriate fashion, or discard the waste safely. They frequently relied on commercial advertisements for the best pesticide to use. Pesticide use patterns among small-scale farmers in Thailand need improvement. Educational interventions are essential for promoting safety during all phases of pesticide handling. Public policies should be developed to encourage farmers to change their pest management methods from chemical based to methods that are healthier and more environmentally friendly.