Down syndrome (DS) represents the most common chromosomal abnormality associated with intellectual impairment. They show many oral health problems in which periodontal disease is the most significant. This research aimed to evaluate the oral hygiene practices and its association with the gingival health condition in a group Down syndrome children. Patient assessment chart of Pediatric Dentistry and Public Health Department was used to record the children’s personal and clinical data. Oral hygiene practices of the children were recorded using a questionnaire filled with the examiner and data was taken from the children’s caregivers. Questions were translated to the parents in Arabic and answers were in the form of Yes/No. The first question was about the frequency of tooth brushing and whether it is twice, once, irregular or none. The second question was whether fingers, toothbrush or nothing is used for teeth cleaning. The third question was whether parents assist their children in brushing or not. The fourth question was if bleeding takes place upon brushing, eating, spontaneously or none. The fifth question was about regular dental visits. Clinical examination was carried out to assess the child’s oral health status. All patients were examined by the same operator under standardized technique using dental mirrors, explorers, good light source and mouth props