American cutaneous leishmaniasis (ACL) is considered a public health problem worldwide, and incidence in Colombia is 12,000 cases per year. Colombia has implemented control programs for years which have often overlooked the social, economic, and demographic characteristics of the regions where the disease occurs. As part of an epidemiological study, this article presents the results of a survey on knowledge, attitudes, and practices (KAP) related to leishmaniasis in rural populations in Acandi in the Colombian Darien. Qualitative and quantitative tools were used (ethnography and surveys, respectively). The results show scarce knowledge among the population on basic aspects such as recognition of the sand fly vector. There were also differences in KAP according to gender and type of population, rather than by geographic area. The study points to government neglect as a critical factor in the persistence of the disease.