Child malnutrition is one of the most serious public health problem in the developing worldrnincluding Ethiopia. Recent survey in the country show that 38% of children are underweight,rn10.5% wasted and 46.5% are stunted. However, underlying variations of these nutritionalrnindicators and determinant factors among regions and localities is poorly understood.rnThe main objective of the study was to assess the prevalence of child malnutrition and identifyrnthe various causes and their relative contributions in urban and rural settings.rnA comparative cross sectional study was conducted in Gimbi district, Oromia region on arntotal of 490 children (310 from rural and 180 from urban areas) of age 6-59 months in Marchrn2007. A multistage systematic sampling method was employed to collect quantitative datarnusing structured questionnaire and anthropometric measurements. The study variablesrninclude; socio-economic and demographic characteristics, child and maternal relatedrnvariables and environmental health conditions.rnData were processed using EPi-info soft ware and exported to SPSS for analysis. NCHSrnreference population standard of WHO utilized to convert height and weight measurementsrninto Z-scores of the H/A, W/H and W/A indices considering age and sex of the children.rnBivariate and multivariate logistic regression analysis methods were used to identifyrndeterminants of nutritional status and to account for potential confounding factors.rnThe result of the study indicated that 15.9 percent of the children were wasted, 32.4 percentrnwere stunted, and 23.5 percent underweight. Prevalence of severe wasting, stunting andrnunderweight respectively were 5.7%, 15.7%, and 8.0%. No significant variation of childrnmalnutrition by residence was observed.rnMain determinant factors of wasting were childhood illness indicated by fever, low householdrnincome and maternal lack of education. Low birth size of children, paternal lack of education,rnmaternal lack of decision making on use of money and lack of animals were associated withrnviirnchronic malnutrition (stunting). ARI in children, lack of windows of houses and low maternalrnBMI (