Background: The development of preschoolers' hand skills may be impacted by touch screen technology. Objective: The purpose of this study was to investigate the effect of touch screen devices use on fine motor skills of preschool children. Subjects and Methods: The study sample included 50 children aged 4-5 years who had frequently used interactive tablet media (group A) and 50 children matched for age who hadn't used interactive tablet media (group B). Fine motor skills were evaluated using Peabody Developmental Motor Scale-2 (PDMS-2). Both groups' socioeconomic position was similar and assessed by the Socioeconomic Status Scale (SES). Results: There was a significant decrease in raw score of grasping and visual motor integration of group A compared with that of group B (p < 0.05). There was a significant decrease in age equivalent of grasping and visual motor integration of group A compared with that of group B (p < 0.01).  There was a significant decrease in standard score of grasping and visual motor integration of group A compared with that of group B (p < 0.01). There was a significant decrease in percentile rank of grasping and visual motor integration of group A compared with that of group B (p < 0.01). Fine motor skills of group B were better than those of group A. Conclusion: The fine motor skills of preschool children who do not use touch screens are better than those of children using a touch screen.