Abstract: Objective To examine current situation of knowledge, attitude and practice(KAP)about oral hygiene and its influencing factors among elementary students of sixth grade in Macao Special Administrative Region of the People's Republic of China(Macau)and to provide evidences for making strategies for health education and intervention on oral health in the area.Methods Stratified cluster sampling was used to select 259 sixth grade students from 12 elementary schools proportionally in Macau and a questionnaire survey was conducted among the students.Results The students had a low level knowledge on oral health, with a correct answer rate of 47.9% for overall oral health knowledge, a score of 3.93 for general oral health attitude, and a score of 2.81 for overall oral health behavior.The knowledge and the attitude of oral health care had positive correlation(r=0.215, P<0.01);the score for oral hygiene attitude of girls was higher than that of boys(75.36 vs.72.81, t=-2.396;P<0.05).The oral health behaviors of the students had positive correlation to their mothers' education level(t=-3.251, P<0.01).The oral health behavior of the students with regular oral examination accompanied by their family members was better than the students without familial support on oral health(t=-3.571, P<0.01).Conclusion Although having positive attitude, more than a half of sixth grade elementary school students did not have correct knowledge about oral health care and a majority of the students did not have oral health behaviors.