Background <p>The expansion of agricultural and livestock production has increased environmental and health concerns for rural communities living near these activities. The aim was to assess odor perception, health conditions, household pesticide use, and the presence of chlorpyrifos residues in flies in rural communities located near a swine production facility in the Maule Region, Chile.</p> Methods <p>A cross-sectional study was conducted with 82 adults residing within approximately 10&#xa0;km of the “El Arbolillo” area in Maule Region, Chile. Structured questionnaires assessed odor perception, health conditions, and domestic pesticide use. Flies were collected in a subsample of households (<i>n</i> = 17), and chlorpyrifos residues were analyzed using gas chromatography–tandem mass spectrometry.</p> Results <p>A total of 61% of participants rated odors as extremely strong. Household pesticide use was reported by 69% and was more frequent in homes located closer to the facility (<i>p</i> = 0.001), and associated with higher odor discomfort (<i>p</i> = 0.006). Chlorpyrifos residues were detected in 68% of sampled households (median: 0.106 ng mg⁻¹). After adjustment for age and sex, higher odor discomfort was associated with hypertension (OR = 3.28; 95% CI: 1.46–9.39), reflux/gastritis (OR = 3.34; 95% CI: 1.23–9.08), shortness of breath (OR = 2.72; 95% CI: 1.05–7.05), and loss of appetite (OR = 2.91; 95% CI: 1.08–7.81). Household pesticide use was associated with migraine (OR = 5.06; 95% CI: 1.40–18.3), gastritis/ulcer (OR = 6.09; 95% CI: 1.53–24.3), and allergic contact eczema (OR = 5.31; 95% CI: 1.22–23.1).</p> Conclusions <p>These findings describe co-occurring environmental exposures, including odor, domestic pesticide use, and pesticide residues in flies. The results support the need for strengthened environmental surveillance and mitigation measures in affected communities.</p> Trial registration <p>Not applicable.</p>