A wastewater treatment plant is associated with many inherent occupational hazards that could have serious effects on the health of sewage workers. Sewage workers are exposed to a variety of hazards associated to the design and operation of the plant, which can lead to accidents and health issues. Aim: Evaluate the effect of the educational program on occupational health and safety behaviors among sewage worker in Egypt. Design: A quasi-experimental one-group pretest-posttest was utilized. Sample: A systematic random sampling was used, and 230 workers were included. Setting: the study was carried out at Zenin wastewater treatment plant. Study tools: two tools were used: 1- Sewage Workers' Assessment Questionnaire [Demographic characteristic, occupational and medical data, sewage workers’ knowledge, and self-reported behavior].2-Sewage workers' occupational health and safety beliefs. Results: Revealed that 2.30%, 65.20%, 56.50%, of sewage workers had satisfactory level of knowledge in pre, post and follow up tests respectively. While 8.7%, 77.80% and 69.50% of sewage workers had satisfactory level of selfreported behavior in pre, post and follow up tests respectively. Moreover, there was a significant improvement in positive workers’ health beliefs score in post and follow up test. Also, there was a highly statistically significant correlation between workers' knowledge, Health beliefs score and self-reported behaviors pre, post and follow up test (p=0.0001). Conclusions: There was a highly statistically significant difference between sewage workers' mean total knowledge scores, self-reported behaviors scores, and health beliefs score in pre-, post-, and follow-up tests after implementations of the educational program. Recommendation: Continuing to organize educational programs for sewage workers on occupational health and safety behavior that covers all wastewater treatment plants in different settings in Egypt.