The Jamaican food safety regulatory framework is embodied in the Public Health Act of 1974 with public health inspectors/ environmental health officers (PHIs/EHOs) empowered with its enforcement. The North East Regional Health Authority (NERHA) has consistently faced challenges in achieving national certification targets for food-handling establishments (FHEs). The aim of the authors' study was to identify and describe noncompliant FHEs and to identify factors influencing their noncompliance. FHEs (N = 248) were randomly selected and each owner/operator targeted for interview. Substantially more FHEs were compliant and respondents from compliant FHEs were more likely to have a valid food handlers' permit. Urban FHEs were less likely to be compliant than rural. The major barriers to compliance were forgetting to apply for a license and lack of money to correct infractions. NERHA should encourage FHE owners/operators to assume greater responsibility for the certification of their premises and to hold PHIs more accountable.