Background <p>Cholera remains a major public health concern in Ethiopia, particularly in conflict-affected agro-pastoral regions where access to healthcare, clean water and vaccination is limited. The main objective was to identify predictors of time to recovery from cholera among patients in a conflict-affected agro-pastoral area of Ethiopia using survival analysis models. Understanding the clinical and epidemiological factors influencing recovery time is critical for improving outcomes and guiding outbreak responses.</p> Methods <p>A retrospective cohort study was conducted using data from cholera treatment centers in a conflict-affected agro-pastoral region. Time to recovery was analyzed using Kaplan-Meier recovery curves, Cox proportional hazards, and Accelerated Failure Time (AFT) models. Variables included clinical signs, demographic factors, vaccination status, and exposure history.</p> Results <p>Severe dehydration (HR = 0.49, <i>p</i> &lt; 0.0001; TR = 1.49), low pulse rate (HR = 0.69, <i>p</i> = 0.005), and lack of vaccination (HR = 0.56, <i>p</i> &lt; 0.0001) were associated with significantly longer recovery times. Notably, patients with known contact with cholera cases showed slower improvement (HR = 0.63, <i>p</i> = 0.0003), suggesting higher exposure or delayed care-seeking. Vaccinated individuals and those with mild dehydration recovered significantly faster. The log-Normal AFT model confirmed these findings, showing prolonged recovery among high-risk groups.</p> Conclusion <p>In conflict-affected agro-pastoral settings, clinical severity, vaccination status, and exposure history are key determinants of cholera recovery time. These findings underscore the importance of early case detection, aggressive rehydration, and targeted vaccination, especially among known contacts and high-risk individuals. Public health interventions should prioritize rapid response strategies and contact-based follow-up to reduce disease burden and improve recovery outcomes.</p>