OBJECTIVES: According to the IRAN NCRUM (National Committee Rational Use of Medicine) reports, assuming each prescription as an individual patient, 45% of patients received antibiotics. Decreasing of infections in the school community by improving of hygiene lead to decrement of consumption of antibiotics in children. The objective of this study was to assess the impact of the effectiveness of the puppet plays in improving children’s knowledge about hand washing and using normal saline to Rinse nose and throat to decrease the spread of infection and unnecessary antibiotic use. METHODS: Evaluation was undertaken with 4 grade students (10 years) in primary schools in Fasa. 200 Students watched puppet plays in 5 groups which each groups contain 40 students. During the experiment, 2 puppet shows were used in one day. Then Students were required to complete identical knowledge questionnaires at two time points (before, and immediately after puppet show), to assess knowledge change. The questionnaires had 4 type questions include: group 1 about story, group 2 about hand washing, group 3 about how to use normal saline and group 4 about rational use of medicine. RESULTS: Our results demonstrated a significant improvement in student's knowledge in all groups after puppet plays (P<0.0001). CONCLUSIONS: Although the puppet plays has significant improve in knowledge of the students, modifications are needed in puppet plays for more achievement.