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Background: Little is known about how the COVID-19 pandemic has affected food security and livelihoods in Sri Lanka. Objective: This article aims to assess food insecurity, perceived effects of COVID-19, and coping mechanisms among agriculture-based households in rural Sri Lanka. Methods: We used 2 rounds of panel data from phone surveys (n = 1057 households) conducted in 5 districts. Food insecurity (30-day recall), perceived impacts of COVID-19 (6-month recall), and coping mechanisms (6-month recall) were assessed using a household questionnaire. To assess food insecurity, we used the 8-item Food Insecurity Experience Scale. We tested for differences between T1 (baseline: December 2020-February 2021) and T2 (follow-up: July 2021-September 2021) and explored the association between food insecurity and the perceived effect of COVID-19 on income using a logistic regression model. Results: Food insecurity was highly prevalent (T1: 75%, T2: 80%) but varied across districts. Most respondents were affected by COVID-19 and/or COVID-19-associated mitigation measures (T1: 84%, T2: 89%). Among affected households, commonly reported impacts included those on income (T1: 77%, T2: 76%), food costs (T1: 84%, T2: 83%), and travel (∼90% in both rounds). Agricultural activities were also adversely affected (T1: 64%, T2: 69%). About half of COVID-19-affected households reported selling livestock or assets to meet basic needs. Households whose income was impacted by COVID-19 were more likely to be food insecure (adjusted odds ratio: 2.56, P <.001). Conclusions: Households in rural Sri Lanka experienced food insecurity and livelihood disturbances during the COVID-19 pandemic. Additional surveys are needed to assess recovery post-COVID-19 and to understand if programs that support livelihoods have been protective. Plain language title: Food Insecurity and Perceived Effects of COVID-19 on Livelihoods in Rural Sri Lanka Plain language summary: Background: Sustained levels of high food insecurity are associated with a range of negative health, nutrition, and well-being effects. The COVID-19 pandemic is expected to aggravate food insecurity and worsen the livelihood situation. Little is known about how the COVID-19 pandemic affected food security and livelihoods of agriculture-based households in rural Sri Lanka. Method: This original article used household level survey data from 2 rounds of phone surveys conducted in 5 districts of Sri Lanka. Using a household-level questionnaire, we recorded experience of food insecurity in the last 30 days, perceived impact of COVID-19, and adopted coping mechanism in the 6 months prior to the survey. We reported statistical means and tested for differences between 2 survey rounds. We also explored association between food insecurity and the perceived effect of COVID-19 on income. Results: Household-level food insecurity was highly prevalent during the pandemic. Households perceived a negative effect of the pandemic on their income and employment sources. Households whose income was impacted by the pandemic were more likely to be food insecure. Conclusion: Agriculture-based households in rural Sri Lanka experienced food insecurity and livelihood disturbances during the COVID-19 pandemic. Additional research is needed to assess recovery post COVID-19 and to understand whether livelihood support programs have been protective. [ABSTRACT FROM AUTHOR]