AIM: This article provides information about the history, recent curriculum changes and the legal status of the dental hygiene education in Nepal. It also intends to show, how, even in a poor developing nation, the personal drive of a native Nepalese citizen with a vision and the proper connections can lead to the establishment of a new profession, until then unknown. METHOD: Data were obtained from the founder of the first dental hygiene school in Nepal through qualitative interviews, and through personal visits to two Nepalese dental hygiene schools in Kathmandu and in Pokhara. Since 2006, the first author serves as curricular advisor, allowing him access and input to drafts of the development of current curricular changes. RESULTS: In 2000, the first dental hygiene course started in Kathmandu. Since then, dental hygiene education has been going through different stages of development and professionalization. In 2005, the programme was changed to 3 years in length in order for students to obtain an academic Certificate in Dental Hygiene. In 2006, the Nepalese Dental Hygienists Association was founded, resulting in greater recognition of the profession, especially by the powerful Nepalese Dental Association. Obscure rules and legislation results in eclectic specifications governing dental hygiene practice. Future challenges for the schools and the dental hygienists association are issues of quality insurance and scope of practice suitable for a developing country. Currently, Nepal is the only country worldwide with an almost equal gender distribution in the dental hygiene profession.