Aim and objective: The aim of the present study was to assess of knowledge and practices regarding drinking water and sanitation among rural area of Gaya district bihar . Material and methods: This community based cross sectional study was done in the Department of Community Medicine, Anugrah Narayan Magadh Medical college, Gaya, Bihar, India from October 2019 to August 2020. The sample size of the study was finalized to 100 houses Structured questionnaires were prepared, which include the basic sociodemographic profile, knowledge and practice questions regarding drinking water and sanitation of households in the rural communities of the study area. The questionnaire was pre-tested in few selected household. Interview was conducted face to face and study subjects were enrolled till the required sample size was met. Information was collected by interviewing the available adult family member at the time of visit, and also, by physical examination of facilities. Results: Out of 100, 24(24%) of them were illiterate, out of whom 56 (56%) of families belonged to middle class and 20(20%) of families belonged to the upper socioeconomic class. Most of households had knowledge about the importance of covered drinking water 94(94%) followed by clean drinking water 85 (85%), cleaning of river/pond water 68(68%), covered garbage dustbin 61(61%), sanitary toilet 83(83%) and hand wash after toilet 93(93%). A total of 100 households were visited for the study purpose. Most of the respondents were adult females 55(55%) and belonged to 20-40 years age group 52 (52%). The most common occupation of head of household was skilled 40(40%) followed by unskilled 28 (28%). We found that the access to water facility was 100% as all the houses derived water from sources. Drinking water was found 91(91%) and majority households 82(82%) collected water for drinking purpose from pipeline followed by remaining others 18(18%). They were travelling for fetching drinking water 108 (52%) outside of premises followed by 48(48%) within premises. It was seen that majority 42(42%) households used boiling method for purification of drinking water followed by 37 (37%) of them treat drinking water by other methods and 21(21%) households did not use any treatment for purification of water. Average 53(53%) households had uncovered garbage dustbin, garbage found openly in premises 57(57%) and households were had a toilet facility within premises 59(59%), households without toilet facility who used open air defecation 31(31%), households did not use footwear for toilet 23(23%), households washed their hands after toilet with soap 63(63%) and remaining by others like as Ash, Mud, Plain Water 37(37%). Knowledge of clean drinking water was significantly related with practice of covered water 81(81%), distance of source 41(41%). Similarly, knowledge regarding covered drinking water 89(89%) was significantly associated with practice of cleaning and disinfectant for drinking water. Knowledge of covered garbage dustbin was significantly associated with practice of covered garbage dustbin 39(39%) and garbage found openly in premises 33 (33%). Likewise knowledge of sanitary toilet was significantly associated with practice of toilet within premises 56 (56%) and hand wash after defecation 54(54%). Toilet within premises 39 (39%) and sanitary toilet within premises 65 (65%) had shown significant association with soap hand washing practice. Conclusions: Knowledge was good enough but unhealthy practices make health education very important for better use of existing facilities and also to prevent the incidences of water and sanitation related diseases.