This study aimed to identify and prioritize risk factors associated with acute diarrheal diseases in children under five years of age in El Chical parish, Ecuador. It was carried out through a multicriteria analysis using the Analytic Hierarchy Process method, based on a survey of a sample of parents or guardians. The data collected included information on water quality, hygiene practices, child nutrition, and immunization. The results showed that most households used untreated water sources, which represented a significant risk. In addition, a considerable portion of respondents did not consistently treat water, and hygiene practices such as handwashing were inconsistent. The nutritional status of children also showed deficiencies, with 22% showing signs of malnutrition. The AHP allowed identifying that lack of water treatment and poor hygiene practices were the most critical factors to address. The study concluded that improving access to treated water and promoting greater education on hygiene practices and infant feeding are essential to reducing the incidence of diarrheal diseases in the community