Background: Self-medication is tremendously insecure practice as it increases morbidity and mortality in many developing and underdeveloped countries. Aim of study: Assess patterns of self-medication practices of mothers having under-five children in El-Beheira governorate. Research design: A descriptive cross-sectional design. Settings: This study was conducted at eight governmental primary health care centers in El-Beheira governorate. Tools: Three tools were used to collect the necessary data. It was developed by the researcher. Results: Majority of mothers who obtained a poor level of knowledge had unsatisfactory practices. Conclusion: Most of the studied mothers in El-Beheira governorate had a poor level of knowledge, and more than half of them had unsatisfactory self-medication practices. Patterns of self-medication practices were inversely affected by their mothers' age, level of education, occupation, residence, number of children, monthly family income, and duration taken to reach the nearest health facility (minutes). Recommendations: The Ministry of Health and Population (MOHP) implements their regulations to enhance the sale of prescription-only medicine (POM) and prohibit selling medicine without a prescription. Enhance the accessibility of health with cost effectiveness, especially in rural areas.