Hand washing is a very important public health tool in disease control. The control of some of the leading causes of under-five morbidity and mortality is greatly enhanced when mothers and other care-givers adopt appropriate hand washing practices. The study was done to assess the knowledge and practice of hand washing by mothers and caregivers of children less than five years with a view to recommending ways of enhancing the practice in rural communities. This was a cross-sectional survey using a cluster sampling technique. A sample of 513 mothers and care givers was drawn from selected quarters in Usugbenu-Irrua and studied with interviewer-administered questionnaires. A scoring system designed by the research team was used to assess the knowledge of respondents. The mean age of mothers interviewed was 31.6 (±9.2) years. Over two-third (70.6%) of them had good knowledge of hand washing. Fifty-six percent reported regular washing of hands at critical moments; hand washing was highest after defecation (79.6%). There was no statistically significant relationship between the knowledge and practice of hand washing (df=1, X2 = 2.796, p = 0.094). The commonest reasons given for not washing hands regularly were: being too busy (19%) and non-availability of soaps (17.7%) and water (13.5%).The findings showed that though there is a gap between knowledge and practice of hand washing, it is not statistically significant. The study indicates that other factors beyond knowledge may be responsible for poor hand washing behaviour.