Introduction: Hand hygiene, either by hand disinfection or hand washing remains to be most pivotal in controlling infection in healthcare settings. Simple preventive measures have been proven effective to contain infections. The exiguity on studies done in healthcare settings in India has galvanized us to undertake this study on hand hygiene assessment among nurses in a healthcare setting in India Materials and methods: A cross sectional study was done in one of leading organization in preventive and promotive healthcare in India. . Hand Hygiene Self-Assessment Framework 2010 by World Health Organization was the tool used for the study. The tool had 5 components envisaging education and training, system change, institutional safety, reminders and evaluation and feedback for hand hygiene. Data was entered in Microsoft Excel and percentages were derived. Results: Among 120 medical rooms, 57% of the medical rooms had basic hygiene, while 32% had intermediate hygiene levels and 11% of the medical rooms had advanced hygiene levels. Conclusion: An advanced level of hand hygiene program with elements of infection control should be offered to the all the professionals working in healthcare setting. Cultural and behavioural issues would play in role in low compliance despite of the efforts to improve quality of healthcare.