Background Developmental delays in children are assessed in four basic domains: gross motor, fine motor, social, and language. Early years of life are crucial in a child’s development, so it is imperative that parents be aware of developmental milestones to facilitate early diagnosis and treatment in case of a developmental delay. This study aimed to assess parental knowledge, attitude, and practices regarding children's developmental milestones and associated “red flags”. Methods A cross-sectional study was conducted at the Department of Pediatrics at Liaquat National Hospital, Karachi. 390 parents, who had at least one child under 5 years of age, with no diagnosed developmental delay, were interviewed during outpatient visits to clinics. The questionnaire consisted of three components to assess parental knowledge, attitude, and practices. Results 59% and 54% of parents had poor knowledge of gross and fine motor milestones respectively;88% incorrectly answered the age at which a child should walk along a straight line. In the social domain, 56% of the respondents had unsatisfactory knowledge. 42% had inadequate knowledge of language milestones; 83.3% did not know the age at which children should be able to respond to their name. 29% of parents strongly agreed that their Pediatricians provide satisfactory information regarding red flags of developmental milestones. 60% of parents strongly agreed that their child’s developmental delay would be a cause of concern for them. In case of developmental delay, 55% of parents said they would consult a general pediatrician, 11% preferred a pediatric neurologist, 21% opted for a developmental pediatrician and 13% opted for a family physician. Conclusion The majority of our respondents showed considerably poor knowledge regarding developmental milestones. This highlights the need to devise ways to educate parents on this subject to enable them to vigilantly monitor their child’s developmental status and any associated abnormalities and ultimately facilitate the right course of action.

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