Planning for human–carnivore coexistence requires detailed understanding of the ecological and sociological circumstances associated with conflict, particularly in multi-use, human-dominated landscapes. We investigated the influence of socio-ecological factors on human–sloth bear (Melursus ursinus) conflict in a human-dominated landscape of Balasore Wildlife Division, eastern India. We examined human–sloth bear conflict data from 12 years (2002–2013) and assessed the attitudes of the people toward sloth bears through semi-structured interviews with 350 people. We recorded 167 human–sloth bear conflict incidents, including 201 human casualties (4 deaths, 104 permanent injuries, and 93 minor injuries) and 7 retaliatory killings of sloth bears. More human–sloth bear conflict occurred during the monsoon season (Jul to Oct) than in other seasons. Monsoon is the peak growing season, when villagers spent more time outdoors farming, including near forest. In addition, lack of toilets in the villages may increase vulnerability of humans to sloth bear attacks. Most people considered sloth bears to be unpredictable and dangerous, which suggests protection and conservation activities may not retain public support. Approaches to mitigate human–sloth bear conflict should emphasize avoiding sloth bears when they are sighted and conducting activities near forests during the day and in groups when possible. Strategies such as improving sanitation facilities, developing effective compensation schemes, forming conflict management teams, and establishing sloth bear conservation awareness programs for villagers, as well as improving cooperation among various stakeholders, are necessary to foster human–sloth bear coexistence.