Background: Malnutrition is a major public health issue plays an important role in the economic burden of society in developing countries. Children with acute malnutrition as a result of inadequate food supply caused by social, economic, and environmental factors Aim: The purpose of this study is to investigate the numerous risk factors and clinical presentation in severe acute malnutrition children Methods: This cross sectional observational study was conducted in KD Medical College Hospital and Research Centre, Mathura, U.P. A total of fifty children under the age of 5 year were enrolled Patient's clinical profile resulted from a thorough anthropometric examination, analysis of related risk factors, and analysis of comorbidities were recorded. Results: Among total cases of acute malnutrition, majority of them (38%) were 13-24 months of age group with slightly female predominance (56%). Most of them (60%) resided in rural area, 42% from lower socio-economic class and 58% were belongs to joint family. Low birth weight (66%), absence of 6 months exclusive breast feeding (70%), delayed or inadequate complimentary feeding (46%) and incomplete immunization (38%) were common predisposing factors. The common clinical presentation were Weakness (63%), Lethargy (54%), Diarrhoea (35%), Skin changes (35%), Fever (33%), Hair changes (32%), muscle wasting (30%), and Oedema (24%) among malnourished children. Conclusion: Young maternal age, maternal education levels, socio-economic class, family size, baby's birth order, length of breastfeeding, consumption of formula milk, and immunization of children play a significant impact on severe malnutrition in young children