Background: The chronic use of khat, a plant with psychostimulant properties, has been associated with physical and mental health problems. Previous research found that non-khat users were more likely than khat users to perceive its use to be associated with poor health. Aims: We aimed to identify differences in the perception of specific khat-associated health problems between khat users and non-users. Methods: In 2012, 133 adults (≥ 18 years) from African migrant communities in 4 state capital cities in Australia completed questionnaires to ascertain their perception of whether specific health problems were associated with khat use. Multivari-able log-linked Poisson regression was used to compare the perceptions of the 2 groups and identify differences, adjusting for sociodemographic factors, tobacco use and years living in Australia. Results: Overall, 58 (44%) and 75 (56%) participants reported current khat use and no use respectively. Adjusted log-linked Poisson regression showed that people who use khat were less likely than non-users to perceive certain health and related problems were associated with khat use, including, poor health in general [prevalence risk ratio (PRR) = 0.86; 95% CI: 0.75, 1.00]; laziness (PRR = 0.86; 95% CI: 0.75, 0.99); stomach and throat problems (PRR = 0.83; 95% CI: 0.72, 0.96); and teeth, gum and mouth problems (PRR = 0.81; 95% CI: 0.67, 0.99). Conclusions: Khat users are less likely to perceive use being associated with health problems than non-users. Providing information on the health problems associated with khat use may be an important component of health promotion strategies and interventions aimed at minimising khat-related harm.