Abstract:The aim of this study was to Assess and compare nutritional status and associated factors of 6 to 59 months old children from food secure and food insecure households in rural Kebeles of Saesie Tsaeda Emba district, Tigray, North Ethiopia. As a result, a comparative, cross sectional study was conducted on 841 children (421 from food secure and 420 from food insecure households) from February to March, 2014. Multistage sampling method was used to select Children from each kebele. Anthropometric measurements were entered and calculated using ENA for SMART 2007software then transferred to SPSS version 20 to be processed and analyzed. Bivariate and multivariable logistic regressions were used to identify associated factors of under nutrition at significance level p-value < 0.05. About (46.1%, 52.1%), (18.1%, 20.5%), and 7.1%, 12.6%) of the children from the food secure and food insecure kebelles were stunted, underweight and wasted respectively. Occupation of father, head of family, and duration of continued breast feeding were the factors associated with stunting in food secure households. Whereas age of the child, head of family, and duration of continued breast feeding were determinant factors for stunting in children from the food insecure households. Similarly, educational status of father, sex of the child, and current breast feeding status of the child were the factors associated with underweight for children from food secure households and age of mother, occupational status of father, sex of child, 1 st complementary food given to the child, and main source of water to the household were the main predictors of underweight in the food insecure households. The factors associated with child wasting in the food secure households were age of the father and number of cattle owned by the household and age of child and main source of water to the household were the factors associated with child wasting from the food insecure households. Finally, under nutrition among under-five years of age children was very high in the population. Therefore, addressing food security and then nutrition security using the productive safety net program in harmony with participation of all responsible bodies is crucial; as children of the food secure households were at better nutritional outcomes when compared to those of food insecure households.