Background: Globally, severe acute malnutrition (SAM) remains a major killer of children under 5 years of age. The highest magnitude is seen in sub-Saharan Africa, including Ethiopia. Hypoglycemia is the most common complication of severe acute malnutrition (SAM) and the most life-threatening condition in pediatric society. This study aimed to assess the prevalence of hypoglycemia and its associated factors among under-five children with severe acute malnutrition.Methods: A cross-sectional retrospective study was conducted among 378 randomly selected samples who were admitted to public hospitals in the East Gojjam zone from 2018 to 2021. Data was extracted from the medical records of the children and entered into SPSS version 26, Variables with a p – value < 0.25 in the Bivariate analysis were candidates for multivariable logistic regression and those with a p – value < 0.05 in the multivariable analysis were considered as having a statistically significant association with hypoglycemia among severe acute malnutrition.Results: Out of 378 respondents, 50 (13.2%) had hypoglycemia with severe acute malnutrition patients. Children admitted between the ages of 0-6 months were 2.93 (AOR = 1.57-6.25, p = 0.000), shocks were 4.6 (AOR = 1.25-17.42, p = 0.034), and fully immunized children were (AOR: 2.61 (1.01- 6.77, p = 0.048) was significantly associated with hypoglycemia with severe acute malnutrition. Conclusion and recommendation: The prevalence of hypoglycemia with severe acute malnutrition was 13.2%. We also recommend a longitudinal study should be done among children who develop hypoglycemia with severe acute malnutrition to determine the long-term consequences, especially the neurodevelopmental sequelae associated with this condition.
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