Introduction: Hand hygiene is a fundamental measure for the control of nosocomial infection. However, sustained compliance with hand hygiene in health care workers is poor. We attempted to enhance compliance with hand hygiene by implementing education, training, and performance feedback. We measured nosocomial infections in parallel. Objectives: to investigate the impact of increase of hand hygiene compliance on device- associated infections rates in Intensive Care Units in Cairo University Hospitals. Patients and Methods: We monitored the overall compliance with hand hygiene in 4 ICUs (Medical ICU, ER ICU, PICU & NICU) from January to July 2011. We divided the program into 3 phases: phase 1(or Pre intervention phase), from January to March 2011 (3 months); and phase 2 (or intervention period), April 2011 and phase3 (post- intervention phase), from May to July. During the study 1647 opportunities were observed in all ICUs for pre and post intervention. Results: Over all compliance for hand hygiene in all ICUs improved from 24.2 to 49.4 (P<.0001).Nurses showed a higher compliance to HH guidelines than doctors pre and post intervention. Over all Device- associated infections rates in all ICUs showed a significant decline and total infection rate decreased from 8.0 \1000 bed days to 3.3. /1000 bed days. Conclusion: A program consisting of focused education and frequent performance feedback produced a sustained improvement in compliance with hand hygiene, coinciding with a reduction in nosocomial infection rates in the ICUs.