Background: Oral health is fundamental to general health and well-being. Little is known about the oral health attitudes and behavior of children from developing countries such as Egypt in comparison with those from developed countries. Objective: To study the oral health knowledge, attitudes, and practice among primary school children in rural areas of Assiut governorate. methods: A cross-sectional school-based study design was carried out. Data were collected by using structured interview questionnaires. The questionnaire was designed to evaluate the knowledge, attitude, and practice of primary school children regarding their oral health and dental treatment. Results: This study included 1036 primary school students distributed along 8 public schools in 4 districts of Assiut governorate. The overall knowledge was satisfactory in 22.2% of students. The overall attitude was positive in 72.3% of students. About 60% of children usually clean their teeth. The most commonly used material for teeth cleaning was tooth brush and tooth paste (65.9%). Parents follow the children during teeth cleaning in 18.9% of cases. 55.6% of children visited the dentist before. In general, the most common cause of dentist's visit was suffering from toothache (75.3%). It was concluded that knowledge and practice about oral health among study participants were poor and needs to be improved. Therefore, comprehensive oral health educational programs for both children and their parents are required to achieve this goal.