Abstract Background: E-learning is the use of electronic devices to conduct teaching synchronously or asynchronously, that allow students to learn from different places especially during pandemic COVID 19. Aim of Study: This study aims to find out which form of e-learning synchronous or asynchronous practical training more effective to acquire knowledge and skills for pediatric physical therapy students. Patients and Methods: Seventy-five undergraduate (5th grade and internship) students selected randomly from different universities, students randomly allocated in two groups, thirty seven students in group A receive synchronous e-learning through zoom life session, thirty eight students in group B receive asynchronous e-learning through recorded video, students knowledge and skills assessed by online quiz designed on Google forms platform, the study carried out from December 2020 to April 2020. Result: There was a significant increase in the quiz total score of group B compared with that of group A (p=0.003) (p < 0.05). Conclusion: The result suggested that asynchronous e-learning is more effective than synchronous e-learning to acquire knowledge and skills for pediatric physical therapy students.