<![CDATA[Introduction: Stunting remains a major public health challenge affecting children under five years of age in many developing countries, including Indonesia. Chronic undernutrition during early childhood can impair physical growth, cognitive development, and long-term health outcomes. Despite national efforts to reduce its prevalence, stunting continues to occur in many regions due to multiple biological, behavioral, and socioeconomic determinants. Therefore, this study aimed to analyze the risk factors associated with the incidence of stunting among children under five years of age in Dolok Sanggul District, North Sumatra, Indonesia. Research Methodology: This study employed an observational analytic design using a case–control approach. The study was conducted from March to July 2023 in Dolok Sanggul District. A total of 240 children under five years of age were included in the study, consisting of 120 stunted children (case group) and 120 non-stunted children (control group). Participants were selected using a simple random sampling technique from the population of registered children under five. Data were collected through structured interviews with mothers and anthropometric measurements using standardized instruments. Statistical analysis included descriptive analysis and bivariate analysis using the Chi-square test to determine the association between risk factors and stunting at a significance level of α = 0.05. Results: The results showed that several factors were significantly associated with the incidence of stunting. Low birth weight (p = 0.040), lack of exclusive breastfeeding (p = 0.030), inadequate complementary feeding (p < 0.001), poor maternal knowledge (p = 0.003), and low household economic status (p < 0.001) were significantly related to stunting among children under five. However, maternal education level was not significantly associated with stunting (p = 0.301). Conclusion: Stunting among children under five is influenced by multiple maternal, child, and socioeconomic factors. Interventions aimed at improving maternal nutrition, promoting exclusive breastfeeding, strengthening complementary feeding practices, and enhancing maternal knowledge are essential to prevent stunting. In addition, policies that address socioeconomic disparities and improve access to health services are crucial for sustainable stunting reduction]]>
