Purpose: Caries prevalence in underprivileged children is particularly high and, even though many efforts have been made, adherence to dental preventive programs is low. The purpose of this study was to evaluate whether a tutoring program can improve oral health behavior in underprivileged and/or immigrant children. Methods: Thirty fourth-grade children (mean age=9.6), over 50 percent of immigrant background, participated in this longitudinal pilot study. The fourth graders were invited to develop an oral health program for their first-grade peers. For this purpose, the fourth graders learned oral health practices and developed the peer tutoring program. Prior to the intervention and after having instructed their first-grade peers, all fourth graders were interviewed about their oral health habits and their tooth-brushing was recorded on video. Tooth-brushing time, performance of circular tooth-brushing movements, and systematic cleaning of all dental surfaces were analyzed before and after the intervention. Results : After peer teaching, there was a significant increase concerning tooth-brushing time (P=.004), performance of circular tooth-brushing movements (P<.001), and systematic cleaning of all dental surfaces (P<.001). Conclusions: The tutoring program yielded a significant improvement in relevant oral care behavior. This approach provided an environment which, in contrast to traditional approaches, facilitates empowerment. Peer Tutoring Pilot Program for the Improvement of Oral Health Behavior in Underprivileged and Immigrant Children. Available from: https://www.researchgate.net/publication/41172059_Peer_Tutoring_Pilot_Program_for_the_Improvement_of_Oral_Health_Behavior_in_Underprivileged_and_Immigrant_Children [accessed Oct 2, 2017].