Background: Down syndrome is a chromosomal disorder resulting in an additional full or partial copy of chromosome 21. The result in varying levels of impairment, from mild to moderate physical and cognitive developmental disabilities and specific physical characteristics and health problem. Aim: The study aimed to assess coping strategies of mothers having primary school students with down syndrome. Research Design: A descriptive research design was utilized to conduct this study. Setting: This study was conducted at special needs school (ALtarbih ELfikria) at Benha City.  Sample: A convenience sample was used in this study for all available mothers  having primary school students with down syndrome and their age from 6 to 12 years old . Tools: Three tools were used. Tool I: An structured interviewing questionnaire, which consisted of five parts. First Part: A) Socio-demographic characteristics of the studied mothers. B) Personal characteristics of the primary school students with Down syndrome. Second part:  Past medical history of primary school students with down syndrome. Third part: Assess health problems regarding down syndrome primary school students. Fourth part: Mothers knowledge regarding down syndrome primary school student. Five part: Reported practices regarding care of primary school students with down syndrome. Tool II: Coping Orientation to Problem Experienced (COPE). Tool III: An observational checklist was used in this study to assess the school environment. Results: 43.8% of the studied mothers aged 40<50 years,56.3 % of them married and 33.8 % of them had university education. 50.0% of the studied mothers had poor level of total knowledge, 32.5 % of them had average level of total knowledge about down syndrome and 17.5 % of them had good level of total knowledge about down syndrome.47.5 % of the studied mothers had satisfactory level of their total reported practices level, and 52.5 % of them had unsatisfactory level of their total reported practices. Conclusion: There was a positive correlation between the studied mothers total score of knowledge, total score of reported practices and their total score of coping strategies level. Recommendations: Preform health education program for mothers having primary school students with down syndrome to improve their knowledge and practices toward prevention of common health problems.