Background & Aims: Regarding the high prevalence of Attention Deficit Hyperactivity Disorder (ADHD) and comorbidity with aggression symptoms, it is significant to apply an intervention to reduce the symtomps. It was aimed to investigate the efficacy of puppet play therapy on aggression of children with attention deficit hyperactivity disorder.

Materials and Methods: This quasi-experimental study had a pretest-posttest design with a control group. The statistical population included all children aged 8 to 12 years with ADHD in Kermanshah city. Then, 24 children were selected as the sample group by inaviable sampling and were divided into experimental and control group. Puppet play therapy intervention program was conducted for 10 sessions. Both groups were evaluated by relational and overt aggression questionnaire (2002) in pre and posttests. Variance and independent t-test were used to analyze the data.

Results: The results showed that the puppet play had a significant effect on reducing total aggression (t= -3.23, P<0.004) and relational ( t= -2.28, P< 0.04) and reveal aggression (t= -7.1, P<0.001) but don’t  have significant effect on physical aggression (t=0.6 P< 0.55).

Conclusion: According to the results of this study puppet play therapy can reduce aggressive behaviuor in children through effect of executive functioning and emotional regulation.