Background: Childhood diarrhoea is a leading cause of morbidity and mortality in developingrncountries, particularly in sub-Saharan Africa including Ethiopia. Poor water handling, unsaferndisposal of excreta and unhygienic practices of mothers/caretakers are some of the risk factors for therntransmission of childhood diarrhea. Improving knowledge, attitude and household hygiene practices ofrnmothers are potentially the most effective means of reducing the burden of diarrhoeal diseases in children.rnOBJECTIVE: To assess knowledge, attitude and household hygiene practice of mothers of childrenrnaged less than five years related to the occurrence of diarrheal disease among under five children inrnAwi Zone, West Amhara region.rnMETHODS: Community based cross-sectional study was employed using both quantitative andrnqualitative research methods from January to February 2010 in 12 rural kebeles of Awi zone, WestrnAmhara region. Kebeles were chosen by random sampling technique. A total of 422 households thatrnhad at least one under-five child were selected by random sampling technique from list of censusrnframe. A structured and pre-tested questionnaire was used to collect quantitative data. Four focusrngroup discussions (FGDs) were also held to generate important idea for the study. Data were enteredrninto EPI Info version 6.04 and it was also edited, cleaned, and analyzed using SPSS version 16.0.rnOdd ratio with 95% CI was employed to test the significant association and multiple logisticrnregressions were also used to control confounders.rnRESULTS: The multivariate regression model showed that children in the age category of 12-23rnmonths were 6.5 times more likely to be affected by diarrhea as compared to those children in thernage category of 36 â€“ 59 months [AOR: 6.48, 95% CI: (2.23,18.84)]. Use of unprotected waterrnsources, poor utilization of latrine and feces seen around the yard were significant predictors for thernoccurrence of childhood diarrhea in bivariate analysis (p