Background: The promotion of insecticide-treated net (ITN) can be a key approach towards the reduction of morbidity and mortality from malaria. Objective: To determine the proportion of mothers using insecticide treated nets for their children and reasons for nonuse. Study design: Prospective hospital-based study. Method: Consecutive mothers attending the children's out patient clinic of UNTH, Ituku-Ozalla, Enugu, whose children presented with fever without localizing focus were interviewed with the aid of an open-ended structured questionnaire. Results: Awareness of ITN was found in 184 (80%) of the 230 mothers interviewed, while only 48 (26.1%) use it for their children. There was statistically significant difference in terms of ITN awareness between the highly educated mothers and those with lower educational qualification (p=0.000) but, in terms of ITN usage, there was no significant difference between the two groups (p=0.40). Socio economic class did not influence the use of ITN (p=0.153). A greater number; 56 (41.2%) have no reason for non-use. Reasons for nonuse include use of windows and door nets 22 (16.2%) and not convenient to spread 18 (13.2%). Conclusion: There was a high awareness of ITN, which did not influence usage. African Health Sciences 2010; 10(2): 117 - 119