Background: Childhood injuries are a major cause of mortality in Sri Lanka, and children aged 2–5 years are particularly vulnerable while attending Early Childhood Development Centers (ECDCs). Objective: This study aimed to assess first aid knowledge, attitudes and practices, and to identify barriers among ECDC teachers in the Central Province. Methodology: This descriptive cross-sectional study included 374 ECDC teachers in Central Province, Sri Lanka, selected via stratified random sampling. Data were collected using a selfadministered online questionnaire and analyzed with SPSS 26.0, using Chi-square tests (p < 0.05). Three district-wise focus group discussions were also conducted and analyzed thematically . Results: females constituted 97 .9% (n=323) of the participants, with a mean age of 40.4±9.63 years. Nearly half (53%, n=175) and over two-thirds (66.4%, n=219) had good knowledge and attitude toward first aid, respectively . 86% of the teachers, who encountered a child in need of first aid gave first aid, but the practices were not in line with the recommended standards. Working experience (p