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The Manggeng Health Center report in 2020 showed that 25.8% of children under five were malnourished, this case was the highest among other health centers. This malnutrition must be prevented immediately because it has an impact on toddlers, namely the disruption of the immune system in toddlers. This study aims to determine the risk factors for the incidence of malnutrition in children under five at the Manggeng Health Center, Manggeng District, Southwest Aceh Regency in 2021.This research is descriptive analytic with a case design with a total sample of 41 undernourished toddlers and a control with a total sample of 41 undernourished toddlers. Data was collected by interview using a questionnaire. The population in this study was 130 toddlers and the sample was determined by proportional sampling technique, namely 82 toddlers. This research was conducted from March 30 to April 12, 2021. The statistical test used was chi square.The results of the univariate study showed that children under five who were undernourished by 50%, low family income 65.9%, insufficient energy intake 68.3%, had infectious diseases 70.7%, food insecure families 65.9%, parenting less good 70.7% and poor health services 73.2%. The results of the bivariate analysis showed that there was a relationship between family income (p value = 0.001, OR = 7.9), energy intake (p value = 0.001, OR = 6.6), infectious diseases (p value = 0.001, OR = 8.5) , availability of food ingredients (p value = 0.001, OR = 6.8), parenting style (p value = 0.001, OR = 9.9), and health services (p value = 0.001, OR = 5.9), with the incidence of malnutrition in infants. The conclusion of this study is family income, energy intake, infectious diseases, availability of food, parenting patterns and health services are risk factors associated with the incidence of malnutrition in children under five at the Manggeng Health Center, Manggeng District, Southwest Aceh Regency in 2021. It is recommended at the Puskesmas provide counseling to mothers how to provide good parenting in caring for and preventing children at risk of malnutrition, such as increasing mother's knowledge and how to make ORS when a child has diarrhea