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Diarrhea remains a major cause of morbidity and mortality globally, and still poses a significant threat to the health, wellbeing and survival of under-fives in many developing countries, especially in Africa. This is despite the existence of simple, effective treatment – zinc plus ORS. A comparative cross- sectional design was used to collect information from 302 caregivers. Data was analysed using SPSS version 20. Utilization of zinc plus ORS by caregivers was found to be good (73.5%) in both settings; up to 120 (78.9%) of the caregivers in the urban community compared to over two-thirds 102 (68.0%) of those in the rural community had used zinc plus ORS. This difference was statistically significant between urban and rural caregivers (P=0.01). Caregivers having poor knowledge of zinc plus ORS were 98% less likely to use zinc plus ORS (P=0.00, AOR=0.02, 95% CI=0.00-0.12), caregivers whose children had non severe diarrhoea are 80% less likely to use zinc plus ORS (P=0.00, AOR=0.20, 95% CI=0.09-0.47) and caregivers in urban areas are 1.5 times more likely to give zinc plus ORS for any episode of diarrhoea (P=0.01. AOR=1.53, 95% CI=1.48-4.54). Utilisation of zinc plus ORS was fair in both rural and urban areas of Kano and continued efforts to reach caregivers using a variety of channels are needed to change caregiver’s knowledge and utilization of zinc plus ORS and alter incorrect diarrhoea treatment practices.