Introduction: The use of pesticides in pest management has increased rapidly and occupational exposures had adversely affect human health. This study investigated the types of pesticides used and their neurobehavioral effects towards mosquito control workers. Methods: A cross-sectional study was conducted among 46 Kelantanese mosquito control workers in two vector control units by using purposive sampling. Risk assessment on pesticides was based on the Chemical Health Risk Assessment (CHRA). A questionnaire was used to assess neurobehavioral symptoms and neurobehavioral performance was conducted using the Neurobehavioral Core Test Battery (NCTB). The individuals’ cumulative pesticide exposure was calculated by average fogging session within a month (session/month) and multiplying with the average duration for each fogging session (hours/session). Results: The risk level was moderate for all pesticides, except for Actellic 50 EC. Neurobehavioral symptoms reported were fatigue after work (80.4%), drowsiness (39.1%), fatigue after wake-up early in the morning (32.6%), and dizziness (32.6%). None of the reported neurobehavioral symptoms was associated with cumulative pesticide exposure (p > 0.05). Cumulative pesticide exposure was associated with Digit Symbol (Adj OR = -0.19, 95% CI: -0.37,-0.01), Digit Span (Backward) (Adj OR = -0.28, 95% CI: -0.31,-0.05), Trail Making (A) (Adj OR = -0.32, 95% CI: -0.37,-0.01),
Minnesota Manual Dexterity (Dominant) (Adj OR = -0.20, 95% CI: -0.38,-0.03), and Minnesota Manual Dexterity
(Non-dominant) (Adj OR = -0.18, 95% CI: -0.36,-0.01). Conclusion: Cumulative pesticides exposures are associated with the perceptual-motor speed, short-term auditory memory, attention, and coordination. Effective risk communication is proposed as one strategy to reduce pesticide exposure in occupational setting.