Village poultry and their owners were frequently implicated in disease transmission in the early days of the highly pathogenic avian influenza (HPAI) H5N1 pandemic. With improved understanding of the epidemiology of the disease, it was recognized that village poultry raised under extensive conditions pose less of a threat than intensively raised poultry of homogeneous genetic stock with poor biosecurity. This paper provides an overview of village poultry production and the multiple ways that the HPAI H5N1 pandemic has impacted on village poultry, their owners, and the traders whose livelihoods are intimately linked to these birds. It reviews impact in terms of gender and cultural issues; food security; village poultry value chains; approaches to biosecurity; marketing; poultry disease prevention and control; compensation; genetic diversity; poultry as part of livelihood strategies; and effective communication. It concludes on a positive note that there is growing awareness amongst animal health providers of the importance of facilitating culturally sensitive dialogue to develop HPAI prevention and control options.