Clean delivery practice is a key intervention for reducing infection-related maternal and neonatal mortality. Understanding local practices is important for designing appropriate interventions. This study was carried out to find out the pattern clean delivery practices in rural area. The study included 248 mothers having children less than 6 months delivered at home were selected from ten VDCs of Sunsari district, Nepal using multistage sampling. Data were collected by using semi-structured interview schedule from 1st January to 28th February 2009. Data were analyzed by using SPSS version 17 for windows. Result of the study revealed the most of birth attendants washed their hands with soap and water before conducting the delivery and more than half of them used soil with cow dung and few (17.7%) deliveries used soil only to clean the floor for delivery of the baby. Three fourth of them used new blade for cord cutting. More than half of birth attendants used thread from Birth kit to tie cord. Only 23.8% of birth attendants applied antiseptic disinfectant to umbilical stump. More than two third used clean cloth for wrapping the babies. The statistically significant association was observed between the occurrence of discharge from the cord and application of different materials (oil, turmeric etc,) to it. Traditional and unhygienic practices at home delivery are common in rural areas having deleterious effect on maternal and neonatal health. Therefore, domiciliary midwifery services have to be carried out by trained and skilled birth attendants.