A growing number of people are entering the artisanal and small-scale mining (ASM) sector worldwide. In Madagascar, millions of individuals depend on this informal activity. Through a case study in the Alaotra-Mangoro region of Madagascar, our research aimed to understand the “bottom-up” dynamics and ripple effects of the sector, by looking at the realities for rural communities where inhabitants are both directly and indirectly affected by ASM. We were interested in community members' and miners' perceptions of the socio-economic and environmental impacts of ASM, and in identifying the factors attracting people living in one of the country's agricultural hubs to this activity. Our results show a wide diversity of push and pull factors leading people to enter the sector. Although many positive impacts of ASM exist for miners and communities within the vicinity of mines, most miner participants considered themselves worse off since starting to mine, highlighting the high risk and low probability of return of ASM. ASM's potential for local and national development will remain squandered if its negative impacts continue to go unmanaged. Accounting for local contexts and the ripple effects of ASM will be crucial in achieving safety and security for miners, and to tap into the benefits it may offer communities while minimising environmental damage.