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Muze Shehmolo,1 Taye Gari,2 Dawit Jember Tesfaye,2 Negussie Boti,3 Bilcha Oumer4 1Department of Disease Prevention and Health Promotion Core Process, Kibet Health Office, Kibet Town, Ethiopia; 2School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia; 3School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 4Department of Midwifery, College of Health Sciences, Arba Minch, EthiopiaCorrespondence: Negussie BotiSchool of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaEmail Hanehalid@gmail.comBackground: Poor school hygiene practice is a major health problem in developing countries, including Ethiopia, and is a leading factor for children’s school absenteeism due to hygiene-related illnesses. To our knowledge, little is known about hygiene practice conducted in southern Ethiopia including our study area. Therefore, the objective of this study was to assess magnitude and associated factors of hygiene practice among primary school children in Mareko District.Methods: A school-based cross-sectional study design with multi-stage sampling was conducted from January 15– 30, 2018 in Mareko district. Out of 25 second cycle primary schools in the district, eight schools (30%) were recruited with a simple random method. Then, a sample size of 829 students was selected by a simple random method. A self-administered questionnaire was used to collect data. Data were entered into Epi Info V. 7 and then analyzed in SPSS V. 20. Multivariate logistic regression analysis was used to identify independent factors of hygiene practice.Results: The magnitude of overall good hygiene practice was 252 (30.4%) with 95% CI (27.3– 33.5%). Practices of hand washing, latrine utilization, and water handling were found to be 191 (23%), 387 (46.7%), and 238 (28.7%), respectively. In multivariate analysis, factors associate