Background: The Federal Teaching Hospital is the only tertiary hospital in Ebonyi State Nigeria. It receives referrals from the general and private hospitals, primary health centers in the state as well as the surrounding state. Breast feeding is a social norm among the indigenes of the state hence practiced commonly. Aim: The study was aimed at determining the knowledge and practice of exclusive breast feeding among the women presenting in the hospital. Methods: This was a cross-sectional study in the maternity unit of the hospital over three months’ period from March to May 2015. A structured data sheet was administered to each mother presenting in the maternity unit of the hospital and willing to participate which were consecutively recruited into the study. Results: A total of 500 mothers participated in the study. About 98.4% were aware of exclusive breast feeding while 90.2% practiced it for different reasons and duration. Only 76.4% practiced it for a period of 4 - 6 months. Majority of the mothers (90.0%) got the information about exclusive breast feeding from the hospital. Times of initiation of breast feeding after delivery were 38.2% within 30 minutes and 33.2% an hour respectively. Seventy six percent of the mothers’ breastfed on demand. About 91.6% were willing to practice exclusive breast feeding for subsequent babies. Surprisingly 10.2% of the mothers discarded their colostrums. Practice of exclusive breast feeding was significantly related to educational status and occupation. Conclusion: Greater awareness and practice of exclusive breastfeeding has been achieved but more still needed to be done especially about the time of initiation, giving of colostrums and the duration of exclusive breast feeding since up to 10.4% of the participants still discarded their colostrums particularly those that delivered outside the hospital.