Cholera was one of the most deadly infectious diseases in the 13th century AH, affecting large parts of Iran. Kurdistan Province, as one of the vulnerable regions in western Iran during the Qajar era, faced an outbreak of this disease almost every year and experienced significant human casualties. The lack of efficient health infrastructure, the region's specific climatic conditions, and trade and geographical connections with the Ottoman territory always exposed Kurdistan Province to the spread of infectious diseases such as cholera. This research, with a descriptive-analytical approach and based on library resources, unpublished documents, and Qajar era press, seeks to answer this fundamental question: What are the factors affecting the spread and spread of cholera in Kurdistan? And what strategies and preventive measures did the local community adopt to combat it? The findings show that factors such as the weakness of the public health system, water and food contamination, population density in cold seasons in confined spaces, the inability of the central government to establish effective health mechanisms, and the lack of a coherent quarantine system played a major role in the spread of this disease. In the face of these conditions, the people of the region also spontaneously adopted strategies such as migrating or taking refuge in the mountains and plains, using tobacco, and avoiding vegetables during periods of disease outbreaks as local prevention methods. The social and economic consequences of this situation included forced migrations, disruptions in trade, famine, and changes in livelihood patterns, which had a long-term impact on the structure of local life.