This study explored the gaps between intended & implemented curriculum of school hygiene and sanitation programs in public primary schools of Nepal. Effective hygiene & sanitation program and its proper implementation can play a vital role in the promotion of positive health, prevention of diseases, raising health consciousness among children, & in providing healthful environment. The findings showed that most schools did not have hygiene & sanitation related facilities that were mentioned in the textbooks and curricula. Where facilities were available they were not properly managed & used Practical classes were ignored. Findings also indicate that irrespective of what is mentioned in the curriculum, it is not possible to effectively implement the intended curriculum without trained teachers, sensitivity on social issues, availability of sufficient facilities & systems for their proper use and maintenance. Thus the content of the existing curriculum and teacher training programs need to be reviewed. Regular supervision & monitoring, including a functional reward and punishment system could help reduce the size of the gap.