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Background: Although the poultry sector accounts for a major portion of global antimicrobial consumption, few studies have explored the factors which influence antimicrobial use (AMU) in poultry farms in Europe. We performed a matched case-control study in traditional free-range broiler farms in France during 2016 to evaluate the effect of technical factors and farmers' perceptions of health problems on the probability of AMU. In total, 52 cases (defined as flocks treated with antimicrobials when chickens were between 1 and 42 days old), were included. Another 208 controls (untreated flocks the same ages as the case flocks), were randomly selected and paired with a matching case (same farmer organization and placement date). On-farm questionnaires were administered. Multivariable logistic regression modeling was conducted; seven variables were significant in the final model. Results: Two factors were associated with a lower probability of AMU: the use of chicken paper topped with starter feed (OR = 0.3; 95% CI = [0.1; 0.9]) and the use of herbal drugs as a prophylaxis (OR = 0.1; 95% CI = [0.01; 0.5]). A higher probability of AMU was associated with farmers perceiving the cumulative mortality of chicks between 1 and 10 days old as normal (OR = 10.1; 95% CI = [1.7; 59]) or high (OR = 58.7; 95% CI = [9.6; 372.3]). A higher probability of AMU also was associated with farmers detecting a health problem (OR = 12.5, 95% CI = [4.2; 36.9]) and phone calls between farmers and their technicians (OR = 5.9; 95% CI = [2.3; 14.8]) when chicks are between 11 to 42 days old. Two additional factors (litter thickness and cleaning/disinfecting) were significant and highlighted the importance of technical factors such as biosecurity. Conclusions: Our results suggest that to reduce AMU, technical training should be provided to farmers to improve how farms are monitored and to reinforce preventive health measures. Training also should address how farmers assess warning criteria like daily mortality rates, which when overestimated often lead to antimicrobial treatment. [ABSTRACT FROM AUTHOR]