In this study, the knowledge, attitudes and practices regarding pesticide use and the levels of exposure of farmers and residents to organophosphorous and/or carbamates pesticides were evaluated in two rural settings in Brazil. A questionnaire was completed by 112 farm workers aged ≥18 years. Almost all farmers acknowledged that pesticides were potentially harmful to their health (87.5%); however, over half rarely (48.2%) or never (7.2%) used personal protective devices (PPDs). An association was found (p = 0.001) between the work regimen and the use of PPDs, with more frequent equipment use among hired laborers than those involved in family agriculture. A significant correlation (p = 0.027) was found between the reporting of adverse symptoms and the use of backpack sprayers. Mean AChE activities of farmers (n = 64) and residents (n = 18) during the exposure and non-exposure periods were significantly lower than their control groups. Mean BChE activities of farmers and residents were significantly lower than their controls during the exposure period. Among the 60 farmers that had blood samples collected in both the exposure and non-exposure (baseline) periods, 10 (16.7%) had AChE depletion of over 30% during the exposure period compared with the baseline level. Six residents living on the same farms also presented this depletion. AChE was over 30% higher than the baseline level for 19 farmers (31.7%), indicating a reboot effect. Special education programs are needed in these regions to promote the safe use of pesticides in the field to decrease the risks from exposure to pesticides for farmers, and from secondary exposure to these compounds for their families.