Background: Diplegia is a spastic form of cerebral palsy with lower limbs more affected than upper limbs. The hand is effector organ of upper extremity for support, manipulation and prehension. Purpose: The purpose of this study is to determinethe effect of push-up exercises on hand grip strength in spastic diplegic cerebral palsied children. Subjects and methods: Sixty spastic diplegic children with age ranged from 4 to 7 years from both sexes participated in this study. They were chosen from physical therapy department, Mubarak Central Hospital, Giza Governorate, Egypt. Subjects were divided randomly into three groups A, B and C, of equal number [twenty patients each]. Each patient was evaluated pre and post-treatment individually by using Peabody Developmental Motor Scale (PDMS-2) to determine standard scores of grasping subtest and age equivalent for fine motor activities and Baseline pneumatic squeeze handheld dynamometer to detect maximum hand grip strength. Control group (A) received traditional physiotherapy program for spastic diplegia and the two study groups (B and C) received the same traditional physiotherapy program in addition to push-up exercises on stable surface for group B in form of wide base push-up exercises, while group C in form of narrow base push-up exercises. The treatment protocol was conducted for three successive months and six times per week. Results: The results of this study revealed significant improvement in hand grip strength, standard scores of grasping and age equivalent in the three groups equally. Conclusion: Conventional physiotherapy program is effective as push-up exercises in improving hand function in spastic diplegic children. Push-up exercises only do not add benefits on hand grip strength.