Health facility survey on diarrhoea case management in Suratthani province was conducted with the objective to evaluate treatment of diarrheal disease in children under 5 years. The data were collected by interviewing public health workers (doctors, nurses and health workers) and child-caretakers and reviewing 425 selected OPD cards of children under 5 years (during 1999-2000) in March, 2001. The study has shown that 66.7% of public health workers assessed the right signs of dehydration. Doctors evaluated and treated for dehydration better than health workers. Norfloxacin was mostly used by doctors for bloody and watery diarrhoea whereas cotrimoxazole was used by health workers. Signs of dehydration were recorded on the OPD cards of 18.3% of patients, and 80% of patients received ORS. The odds of receiving ORS for diarrheal disease were 4 itimes higher in hospital than in health centers (OR = 4.0; 95% CI = 2.4-6.6). IV fluid was especially used in hospital in 8.6% of patients. Antibiotic was used for diarrheal disease in 77.4% of cases and the odds of receiving antibiotics were 2.9 times higher in health centers than in hospitals (OR = 2.9; 95% CI = 1.7-5.0). Cotrimoxazole and norfloxacin were mostly used. Antidiarrheal drugs were used in 2.8% of cases. Child-caretakers' knowledge about increased ORT, continued feeding and signs to visit the physician was correct in 66.7%. ORT corners were only found in tertiary hospital and 3 health centers. ORS and antibiotic were stocked for 3 months. About 20% of health centers had short supply of ORS. Hospitals had more complete health media than health centers. Most media were leaflet and posters. The results suggest that training needs for diarrheal case management should be established, especialy in health centers. ORS promotion and ORT corner should be of concern in health centers and district hospitals. Finally, drug use in diarrheal disease should be more strictly managed andantibiotics used only when indicated.