To screen 4th and 5th-grade school children from urban English medium schools for visual-motor integration(VMI) and how VMI affects handwriting. The objective of this paper is to determine the relationship between VMI and handwriting skill among children of 4th and 5th grade of English medium school in Nagpur city and the impact of visual-motor integration skills on handwriting legibility. Elementary school Children were assessed for Visual-Motor Integration by Beery Buktenika’s Developmental Test of Visual-Motor Integration (VMI) by the examiner. The Beery’s VMI and its two supplemental standardized tests i.e visual perception and motor coordination, provide one of the most valid and economical visual motor screening batteries available for preschool to adult ages. Results- This study shows that percentage of children having standard scores of VMI below average to very low scores was 26.48% which is similar to the standard score interpretation of Beery VMI in which 25% of children fall under the below average to very low standard score category. In this study we found that the percentage of the age group in below average was 12.52% with one standard deviation below the mean, low was 9.79%, and very low was 4.17%, respectively. Whereas in Beery’s VMI Standard Score Interpretation, the percentage of the age group in below average is 16%, low is 7% and very low is 2% respectively. From this, we concluded that in this study, there is a 2% to 2.5% increase in the low and very low-performance category. The results of the item of copying forms from the visual perception show a significant relationship with the quality of handwriting that confirmed the results of other studies these studies used the VMI ( Beery, 2004 ) and a copy of text to measure the quality of handwriting