This study was driven by the underdeveloped Higher Order Thinking Skills (HOTS) of elementary school children as one of the demands of 21st-century learning, alog with the high need for teaching modules in fraction material. This study aimed to create a Realistic Mathematics Education (RME)-based teaching module integrated with design thinking that is valid, practical, and effective in improving students’ HOTS. The method used was Research and Development (R&D) employing the ADDIE model comprises of analysis, design, development, implementation, and evaluation stages. The data were analyzed using Gregory validity testing, practicality percentage analysis, Paired Sample t-test, and N-gain test. The investigation revealed that the teaching module possessed outstanding validity level with a Gregory coefficient of 1 and a excellent practicality level based on student responses of 95.125% and teacher responses of 96.88%. The teaching module was also effective in improving students’ HOTS, as evidenced by the rise in the mean pretest score from 22.8 to 80.6 on the posttest, a significance score of 0.000, and an N-gain result in the high category. The findings of this study strengthen that the integration of the RME model and design thinking in teaching modules is able to improve students’ HOTS in fraction material. The underlaying conclustion of this investigation shows that the teaching module is feasible to be used as an innovative and adaptive learning tool, with influence for the development of mathematics learning based on students’ needs in elementary schools.