BACKGROUND The audience response system (ARS) allows students to respond and interact anonymously with teachers via small handheld wireless keypads. Despite increasing popularity in classroom settings, the application of these devices to health education programming has not been studied. We assessed feasibility, engagement, and learning among children using an ARS compared with traditional pencil-paper formats, (ARS) for a stroke health education program. METHODS We compared outcome data generated via an ARS-based intervention to pencil-paper controls, including test scores and missing data rates among 265 schoolchildren 9 to 11 years old participating in stroke education. Among 119 children, we evaluated the feasibility of ARS use and explored student motivation with a 10-item questionnaire. We assessed facilitator experience with both methods. RESULTS ARS use is feasible. Students reported having more fun (p < .001), increased attention (p < .001), participation (p < .001), and perceived learning outcomes (p < .001) compared with pencil-paper controls. Test scores showed highly positive improvement for both ARS and paper without additional benefits of ARS on learning. There was no difference in missing data rates (p < .001). Educators preferred the ARS. CONCLUSIONS The use of an ARS among children is feasible and improves student and facilitator engagement without additional benefits on stroke learning.