Male partner involvement in maternal, neonatal and child health (MNCH) care has been around for a long time but nothing has been done since nobody has figured out how to do it on a large scale. We assessed men`s knowledge and their awareness of their wives` actual practices regarding MNCH care issues. The study was conducted in four improving maternal, neonatal and child survival` (IMNCS) intervention districts (Nilphamari, Rangpur, Gaibandha and Mymensingh) of BRAC and two control districts (Naogaon and Netrokona) during October 2008-January 2009. Data were collected from 7,200 men whose wives had experienced a pregnancy outcome in the preceding year of the survey or who had live child aged 12-59 months. Chi-squared tests and t-tests were performed for comparing grouped districts and Cohen`s Kappa was used to assess the level of agreement between men and women regarding MNCH practices and decision-making. Significantly more men in Nilphamari had correct knowledge on the initiation of breastfeeding within an hour, colostrum feeding, duration of exclusive breastfeeding, time of complementary food initiation, bathing and shaving of newborn, and neonatal danger signs compared to other areas. Knowledge on birth preparedness was low in all the study areas. Men were more aware about their wives` actual practices regarding use of family planning, experience of abortion and menstrual regulation, receiving any ANC, and place and attendant at delivery compared to postnatal care and maternal complications. There are marked differences in the reports of the men and their wives regarding joint decision-making, where more men tended to report that they took the decision jointly. Though we see some spill-over effect of MNCH programme in Nilphamari which actually addresses the women, the overall men`s knowledge and their participation in practice and decision-making regarding MNCH issues is low in all the study areas. A well designed programme which directly addresses men is essential to raise men`s knowledge and change their practices on MNCH issues.