Background: In child development, the first two years have critical importance. At this stage breast milk is an important source of nutrition but the breastfeeding practice is poor and it is decreasing. The effect of developmental delay is pronounced in developing countries due to limited access to other resources that complement breast milk for mental development. The roles of nutritional and environmental factors on child development need to be studied for possible intervention.rnObjective: To assess the association between duration of breastfeeding and fine motor delay among children aged 20 to 24 months living in Butajira, southern Ethiopia.rnMethod: This study was conducted among 20 to 24 months old children employing community-based case-control study design. Cases and controls were identified by conducting screening among children from 20 to 24 months living in Butajira. Fine motor was assessed using Denver developmental screening test. Independent variables were assessed using interviewer-administered questionnaire. Data were entered on to Epi-data version 4.4.2.1 computer software and exported into STATA version 14 for data cleaning and analysis. Descriptive statistics was determined and binary logistic regression was used for the association. Variables with p-value