Abstract: Background: Practice of open defection has growing health concerns especially on rural dwellers and is among leading causes of diarrhea, typhoid fever, cholera, stunting and responsible for the death of children under 5 years in Nigeria. This study seel‹s to examine knowledge of public health challenges of open defecation among rural residents in south-east Nigeria and implications for social worl‹. Data source and methods: Focus group discussions and in-depth interviews were used for data collected from 52 respondents in Nsukka and Udenu LGAs of Enugu State. Thematic analysis was adopted and phrases with contextual connotations were pulled as illustrative quotes. Results: Lacl‹ of toilet facilities mal‹es community members engage in the practice despite knowledge of its public health implications. Conclusions: The study recommends strengthening of government's efforts to eradicate the practice; incorporating social worl‹ers as facilitators in public health regulations and advocacy in sensitising households to provide their own toilets. Keywords: Knowledge, open defecation, public health, rural areas, social world