OBJECTIVE To review the cholera epidemiology in Zambia from 2000 to 2010 in order to highlight the key lessons learned. Based on our findings, we make recommendations for improving cholera prevention and control in country. DESIGN Ten years descriptive cholera data was extracted from the national IDSR database and analysed. SETTING The study was conducted in Zambia using national epidemiology data which were disaggregated by Province. SUBJECTS None. RESULTS Starting from 2003, there has been a progressive increase in yearly incidence of cholera in the country. In 2010, 6794 cases (500% increase compared to 2003) and 115 deaths (CFR 1.6%) of the disease were reported with Lusaka Province accounting for 85% of the total cases. Outbreaks start between epidemiological weeks 40 to 45 of the year and ends between weeks 20 to 25 of the following year (which corresponds to the Zambian rainy season). Outbreaks are largely confined to the peri-urban areas of Lusaka, Luapula, Southern and Copperbelt Provinces. CONCLUSION In the last 10-20 years, the epidemiology of cholera in Zambia has changed; Laboratory confirmation of Vibrio cholerae in the country on a yearly basis in the last ten years suggests that the country is now endemic for cholera hence the need to review current cholera prevention and control strategies.