Background/Aims: Good oral hygiene practice helps to prevent oral cavity diseases and dental problems. This study aims to assess oral hygiene practices and their associated factors among middle-aged people in a rural municipality of central Nepal. Materials and Methods: This study collected data from 291 middle-aged adults in rural Nepal using a semi-structured questionnaire. The data was entered into Epi-data 3.1 and analyzed using SPSS 22. An oral hygiene score was calculated based on good oral hygiene practices, and chi-square tests and logistic regression models were used to measure associations between variables. Adjusted odds ratios were calculated to measure net effects, with a p-value of 0.05 considered as significant association. Results: The study found that the majority of respondents (80%) brushed their teeth once a day, with over half (56.7%) having poor oral hygiene practices. The majority (60%) changed their toothbrush every three months, and most (98%) used toothpaste but did not know about the benefits of fluoride. A significant association was found between age (p=<0.001), gender (p=0.011), education (p=<0.001), income (p=0.018) and employment status (p=0.037) visits with oral hygiene practices. Females had three times higher odds of good oral hygiene practices than males (OR: 3.51(1.86-6.62)), literate individuals had higher odds of good oral hygiene (OR: 2.04(1.06-3.92). Conclusions: The study found that most respondents brushed their teeth once a day, with over half having poor oral hygiene practices. Gender and education were associated with good oral hygiene practices. The study suggests the need for oral health services and hygiene awareness programs in rural areas.