OBJECTIVES: To assess parents’ knowledge and practice about childhood immunization and to evaluate the association between parents’ knowledge and practice about childhood immunization and their socio demographic characteristics. METHODS: A cross-sectional prospective survey was conducted in ten clinics that provide vaccinations in state of Pahang, the largest state in peninsular Malaysia. Validated immunization knowledge and practice questionnaires were used. Data were analysed using SPSS version 20.0. Mean and median for the total knowledge and practice score were calculated. Parents’ knowledge and practice was dichotomized into adequate and inadequate using median split method. The Chi-square test was used to measure associations between parents’ knowledge and practice and their socio demographic characteristics. RESULTS: A total of 479 parents were participated in this study, vast majority of them were mothers (93.5%, n=448). The mean ± standard deviation (SD) of the total knowledge and practice score was 14.51± 3.78. More than half of the parents (54.9%, n=263) found to have adequate knowledge and practice. Significant associations were noted for knowledge-practice groups with parent’s age, education level, and family income (p<0.05). CONCLUSIONS: Understanding parents’ knowledge and practice is an important factor in order to improve immunization uptake and timeliness. Educational interventions targeting parents with inadequate knowledge and practice about childhood immunization are needed.