Background: School health program addresses the healthcare needs of a substantial proportion of the population in many developing countries, and it is majorly concerned with ensuring that school children are healthy and benefit maximally from their education. Aim: This study was conducted to assess the knowledge and practice of school health program in primary and secondary schools in Sokoto metropolis, Nigeria. Materials and Methods: A cross-sectional study was conducted among 87 head teachers (selected by a two-stage sampling technique) in the primary and secondary schools in Sokoto metropolis, Nigeria. A structured self-administered questionnaire was used to collect data on the research variables. Data were analyzed using IBM SPSS version 20 statistical computer software package. Results: Less than a tenth 7 (8.0%) of the 87 respondents had good knowledge of school health program. Less than half of respondents knew the components (26.4%), services and activities involved (46.0%) and the objectives (48.3%) of SHP. Practice of SHP services / activities was adequate in less than half 41 (47.1%) of the 87 schools. There was no significant difference (p > 0.05) in the knowledge and practice of SHP in the public and private schools. Conclusion: This study showed poor knowledge of SHP among the head teachers, and sub-optimal practice of SHP in the primary and secondary schools in Sokoto metropolis, Nigeria. Review of teachers’ training curriculum to make it comprehensive enough to incorporate all the vital aspects of SHP, and periodic training of teachers on SHP were suggested.