This paper describes tsunami disaster mitigation in the West Sumatra region with participatory technology assessment (pTA), which promotes direct interaction among member and experts to discuss issues and reach consensus for mitigation through provision of information and knowledge of science and technology. Two areas were examined: Padang, the capital city; and Painan city, a town in southern West Sumatra Province, Indonesia. Tsunami have damaged these areas at least three times: in 1797, a 5-10-m-high tsunami wave height hit the area; in 1833, a 3-4-m-high tsunami came; and in 2007, an 8.4 Mw earthquake generated a local tsunami with maximum wave height of 1.5 m, as observed near Painan. Because of the high level of tsunami risk resulting from its flat topographic conditions, their respective populations of 820,000 people and 15,000 people are developing tsunami mitigation efforts with support of national institutions and international experts. These cities had different starting points and approaches. Efforts were introduced to produce official tsunami hazards maps. Insights from these lessons and ideas arising from the ongoing process after the 2007 South Sumatra and 2009 Padang earthquakes are discussed herein. © 2010 World Scientific Publishing Company. Show More