Objective: Each year, humanitarian groups provide health education programmes and interventions to underserved communities in Nicaragua. The purpose of this study was to identify the health education needs of a small community in rural Nicaragua to inform health education programming. Design: Mixed methods approach that used a quantitative survey and a qualitative questionnaire to determine health education priorities. Setting: Rural community in the Jinotega region of northern Nicaragua. Methods: The quantitative survey was completed by 125 participants to gauge the importance of specific health topics, while 49 of those participants also completed a qualitative questionnaire that solicited information about participants' current health knowledge, beliefs and practices. Results: Quantitative results showed that participants ranked the prevention of respiratory illness as their highest education need, while exercise was their lowest priority. Smoking cessation and reducing alcohol use were viewed as significantly higher priorities by men than by women. Qualitative findings revealed five major themes related to reproductive health, respiratory health, nutrition, stress and exercise. Within each theme, participants demonstrated knowledge of health promoting behaviours; however, barriers to adopting healthy behaviours were also evident. For example, some female participants expressed feelings of powerlessness in sexual relationships despite knowledge of how sexually transmitted infections could be prevented. Participants also identified the importance of nutrition but described poor access to healthy foods. Conclusion: Findings from this study provided information to develop future health education programmes that build upon the community's strengths while addressing the health topics most important to residents.