Background: For children with Erb's palsy, difficulties with fine motor control often present as a serious problem that affects their activity of daily lif ADL activities. Objectives: To examine the impact of mirror therapy on fine manual control in children with Erb's palsy. Subjects and Methods: Thirty children with Erb's palsy with their age ranged from 5 to 9 years participated in this study. They were at level 1 on Manual Ability Classification System (MACS) and they were able to follow instruction given to them, they were excluded if they had residual deformity and operation in the hand. They were randomized into two groups: control group (A) as well as study group (B). Both groups were given a designated physiotherapy program as well as control group were given program to improve the fine manual control, while study group were given the similar program but in front of mirror (mirror therapy). Fine manual control was evaluated before and after the treatment utilizing Bruininks Osertesky Test Bot-2, and the program was performed for an hour, 3 sessions per week for 3 consecutive months for all groups.   Results: Both groups showed significant improvement in fine manual control post treatment. Significant improvement after treatment in the fine manual control was found favoring study group (p < 0.05). Conclusion: Mirror therapy can be utilized in the treatment program of children with Erb's palsy to improve the fine manual control.