Background .About 11 million children younger than5 years still die every year even after arnsubstantial decline in child mortality had occurred. The findings that are available so far show thatrnabout two third of child deaths could be prevented by interventions that are available today andrnfeasible for implementation in low income countries .The identification of determinants of childrnmortality is a crucial step in planning and implementation of interventions .rnObjective: To assess the determinants and causes of child mortalityrnMethods. The study utilized a case control study design, Cases and controls were identified byrnpopulation based survey. The study was conducted in Jimma Town from October to Novemberrn2004 .The variables included were socioeconomic, behavioral, nutritional, environmental andrndisease history. The data was collected using structured questionnaire which include standardizedrnverbal autopsy tool.rnResults: Muslim religion(OR=3.41,95%CI(1.37,8.46)) Dawro(OR=6.51,95%CI(2.13,19.88)) andrnYem (OR=4.25,95%CI(1.09,116.48)), never breast fed, (OR=13.74,95%CI(3.34,56.42)) notrnvaccinated children(OR=.26,95%CI(0.10,0.67)) and (OR=3.34,95%CI(1. 27,8.76)) children withrnmotherâ€™s having more than five children are significantly associated with child death . Pneumonia,rnMalaria and gastroenteritis were leading causes of death. Malnutrition (38%)and HIV/AIDS(2.8%)rnhad contributed to a significant proportion deaths.rnConclusion and recommendations: immunization, parity and breast feeding were found to bernprotective from childhood deaths. Despite the limitations of Verbal autopsy, the determination ofrncauses of death using verbal autopsy is of greater importance and value to public health.rnStrengthening the child survival initiatives namely universal child immunization, family planningrnand breast feeding are strongly recommended.