Down syndrome (DS), known as trisomy 21, is the most common chromosomal abnormality among live born infants and is associated with hypotonia and delayed motor development. The study aimed at identifying the effect of therapeutic massage on muscle tone and motor functioning of children with Down syndrome. The study design was a quasi- experimental on a sample of 30 children diagnosed with Down syndrome aged 1- 6 years and their caregivers. Four tools were used for collecting data in the study; the first tool was a structured interview questionnaire for Down syndrome children and their caregivers such as demographical data, clinical data, caregivers ’knowledge of Down syndrome and therapeutic massage. The second tool was a structured clinical checklist to evaluate caregivers ’practice regarding therapeutic massage. The third tool was arm, leg & trunk muscle tone scale used to assess muscle tone of down syndrome children. The fourth tool was Peabody developmental motor scale used to measure motor abilities for children with disabilities. The results revealed statistically significant improvement regarding muscle tone and motor quotients among the studied children. Therefore, it could be concluded that therapeutic massage had great effect on muscle tone and motor function of children with Down syndrome. Based on the results, it could be recommended that an integration of therapeutic massage as a part of routine daily care of Down syndrome children should be implemented. Continuous educational training programs should be developed and implemented for nurses and caregivers of Down syndrome children about therapeutic massage. Key words: Down syndrome, Therapeutic massage, Muscle tone and Motor Function