Background: Deliberate self harm (DSH) is defined as intentional self-injury or self-poisoning, irrespective of type of motivation or degree of suicidal intent.The estimated number of DSH attempts per year in Pakistan is 30,000 to 60,000.It is emerging as a public health problem as DSH attempts are 10-40 times more frequent than completed suicide.The problem needs immediate attention as there is accumulating evidence that incidence of DSH has increased in recent years in Pakistan.Objective: The objective of the study was to assess the knowledge of the research assistants before and after the training for a DSH study, going to be conducted in four tertiary care hospitals of Karachi Pakistan.Methods: This was a cross sectional study conducted in the Emergency Department of Aga Khan University Hospital Karachi Pakistan in November 2010.Thirteen research assistants were trained for a study.The objective of the study for which they were getting the training was to determine the risk factors of patients presenting with DSH to the Emergency Departments of four tertiary care hospitals of Karachi.These hospitals were Aga Khan University Hospital (AKUH), Abbasi Shaheed Hospital (ASH), Civil Hospital Karachi (CHK) and Jinnah Postgraduate Medical Centre (JPMC) Karachi.There were 9 medical gradates and 4 psychologists who were trained for four days.Training included lectures delivered by an Emergency Physician and a Psychiatrist, discussion of the protocol and questionnaire.Mock interviews were also a part of the training.A questionnaire containing 15 questions regarding "DSH and suicide in Pakistan" was given to the research assistants and they were asked to fill it before the start of the training.The same questionnaire was filled at the end of the training.The difference in knowledge was assessed through the scores of the test.These questions were related to definition of DSH, difference between DSH and suicide, numbers of suicides (according to WHO) by the year 2020, risk factors, age and gender, laws regarding DSH in Pakistan, symptoms of major depression, definition of psychological autopsy, methods used, differences in presentation to public and private sector hospitals, role of Emergency Department care, cost of treatment of DSH in Pakistan.Results: The mean age of research assistants were 23 (+/-5) years.There were 11 females (84.6%).The mean scores before starting the session were 6/15 (40%) whereas the mean scores after training were 13/15 (86.6%).Most of the research assistants were unable to answer the questions related to the laws regarding DSH in Pakistan, definition of psychological autopsy, numbers of suicides (according to WHO) by the year 2020 and cost of treatment of DSH in Pakistan before the start of their training.Conclusion: The research assistants are lacking the knowledge related to DSH.Therefore they should be trained before starting the DSH studies.