This review is based on the question AAre community-based animal health systems a realistic option for improving primary veterinary services in Somalia?@ This question has arisen due to positive experiences with community-based animal health in remote, pastoral areas of eastern Africa. Lessons from southern Sudan indicate that well-coordinated, large-scale community animal health worker (CAHW) systems can form the basis for improved service delivery in conflict zones. On a smaller scale, reviews of CAHW projects in dryland areas of Kenya demonstrate substantial cost-benefit through the prevention or treatment of a few important livestock diseases. In some areas, such as the Afar region of Ethiopia, CAHWs have played an essential role in rinderpest eradication. To varying degrees, these areas were characterised by limited government veterinary services, civil disorder and logistical problems related to large systems boundaries and poor infrastructure. These constraints are also highly relevant to the current situation in Somalia/Somaliland.