Background: Hand hygiene is the most effective strategy for preventing healthcareassociated infections (HAIs). Despite WHO recommendations, gaps in knowledge and compliance persist in healthcare settings. Objective: This audit evaluates the current level of hand hygiene knowledge and compliance among healthcare workers in the paediatric units in General Hospital Kegalle. Methods: A descriptive cross-sectional audit was conducted among 45 healthcare workers, of whom 44 provided valid responses (response rate: 97 .8%). Data were collected using a structured questionnaire based on the WHO Hand Hygiene Knowledge Questionnaire (2009 revision). The instrument assessed demographic characteristics, knowledge, self-reported practices, barriers, attitudes, and training. Data were analysed using descriptive statistics. Results: Participants were predominantly female (73.2%) and nurses (54.5%). The overall mean knowledge score was 10.7 out of 15 (71.4%), indicating moderate knowledge. High correct response rates were observed for identifying hand hygiene as the most effective preventive measure (100%) and the main route of cross- transmission (90.9%). However, major gaps were identified in understanding complete hand hygiene indications (30%) and prevention of transmission to healthcare workers (11.4%). Self- reported compliance was high, with 79.5% always performing hand hygiene after patient contact. The main barriers were forgetfulness (38.6%) and workload (34.1%). Although 93.2% perceived hand hygiene as very effective, 54.5% had not received formal training within the past two years. Conclusion: While overall knowledge and self-reported compliance were satisfactory ,significant conceptual gaps and limited recent training highlight the need for regular refresher programs and behavioural interventions to strengthen patient safety practices.