This study assessed smallholder finances and their attitudes towards the Foot and Mouth Disease (FMD) vaccination programme, when 1 620 000 vaccine doses were provided for strategic administration in large ruminants in FMD ‘high-risk’ areas in Laos between 2012 and 2016. Farmers (n = 168) in the provinces of Xayyabouli (XYL), Xiengkhoung (XK) and Huaphan (HP), were interviewed. Over 91% of the farmers responded that their livestock were vaccinated for FMD, with over 86% ranking FMD vaccination as a good or very good intervention. No FMD cases were reported from the vaccinated provinces after May 2013. Examination of the total income per household in XYL, XK and HP indicated earnings of US$5060(±650), US$4260(±294) and US$1691(±676), respectively (P = 0.001), with 23%, 28% and 68% of the total incomes from annual sales of large ruminant, respectively. Of the farmers in XYL, XK and HP, 83%, 93% and 70% (P = 0.009) said their annual income increased compared with 2012, and 47%, 64% and 41%, respectively (P = 0.005), indicated this increase was from additional large ruminant sales. The study indicated that this large FMD vaccination programme was well regarded by participating farmers and may have provided satisfactory suppression of the disease in Laos, despite not achieving the preferred vaccination coverage. Continuation of the vaccination programme in FMD high-risk areas is suggested as desirable.