Stunting is a manifestation of chronic linear growth restriction produced by interacting biological, nutritional, environmental, and social processes rather than by a single exposure. This study analyzes factors associated with stunting among children under five in Tanjungpinang City and develops a locally relevant determinant framework using structured secondary-data analysis and an integrative synthesis of recent peer-reviewed evidence. Official local data were drawn from the 2023 Indonesia Health Survey and the Tanjungpinang City Medium-Term Development Plan 2025–2029, including 2024 routine E-PPGBM growth-monitoring records. Peer-reviewed studies published mainly during 2017–2026 were synthesized across maternal and prenatal conditions, birth outcomes, infant and young-child feeding, dietary diversity, infection and water-sanitation-hygiene conditions, socioeconomic status and food security, household environmental exposure, and health-service performance. The 2023 survey estimated stunting prevalence in Tanjungpinang at 15.2%, whereas 2024 routine monitoring recorded 332 stunted children among 11,130 measured children (3.0%); these figures are not directly interchangeable because they arise from different measurement systems and population frames. Routine 2024 data also showed subdistrict variation, from 1.7% in Tanjungpinang Barat to 4.7% in Tanjungpinang Kota, and higher recorded prevalence among boys than girls. The literature consistently indicates that low birth weight and prematurity, maternal nutritional constraints and anemia, inadequate complementary feeding and dietary diversity, poor WASH and recurrent infection, low socioeconomic resources and maternal education, and uneven access to effective health services can jointly increase stunting risk.