<p>From 2014 to 2021, a total of 14,082 dog bite exposure and 58 deaths from clinical rabies were reported in Tigray, with a case fatality rate of 0.41%, varying increasingly from 0.11% in 2014 to 11.8% in 2021. During the deadly siege and prolonged war in Tigray, clinical rabies deaths were high in Central, Northwestern, and Southern zones, with a 12% of notification rate and a high number of clinical rabies deaths compared to the prewar periods. Poor health-seeking behavior of the community diminished prevention and control measures, and poor coordination between sectors in the concept of the One Health approach was identified.</p>