Podoconiosis (endemic non-filarial elephantiasis) is a neglected tropical disease that causes affected individuals intense social stigma. Although some studies have investigated community-based stigma against podoconiosis, none has yet attempted to assess coping strategies used by patients to counter stigma. This study aimed to describe and categorize the coping strategies employed by podoconiosis patients against stigma. From January-March 2010 data were gathered through in-depth interviews with 44 patients, six focus group discussions (with a total of 42 participants) and two key informant interviews. The coping strategies employed by patients to deal with stigma could be categorized into three areas: active, avoidant and through changing the relational meaning. Of these coping strategies, avoidant coping is the most negative since it encourages isolation and pushes those employing it towards more risky decisions. Many podoconiosis patients are forced to use this strategy through lack of control due to extreme poverty. Intervention programs must therefore create circumstances in which patients are empowered to actively cope with stigma and play a role in stigma reduction.