Background: Self-medication is tremendously insecure practice as it increases morbidity and mortality in many developing and underdeveloped countries. Aim of study to 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 the governmental primary health care centers in El-Beheira governorate. Tools: one tool of data collection was developed by the researchers and include three parts. 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. 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. Educational sessions should be provided for the mothers in MCH regarding medication administration to their children.