Severe acute malnutrition (SAM) affects 16.9(2.5%) million children under 5 years in worldwide. it contributes to 1‐2 million preventable deaths each year and lower early stages of life, child resistance to infections, increase child Morbidity and mortality, and decrease mental development and cognitive achievement. OBJECTIVE The objective were to determine prevalence of severe acute malnutrition & associated factors among children 6-59 months age at Telemet Woreda, north Gondar northwest Ethiopia. METHOD The study conducted from January–February 2018. Community-based cross-sectional study with administrated questioner and anthropometric measurement was used and 422 children 6-59 months of age and care giver/mother participated. To identify factors associated variables outcome, Bivariate and multivariate logistic regression model fitted with declared P-value < 0.2 and P-value < 0.05 respectively. RESULT The prevalence of severe acute malnutrition was 3.6% House hold source of food on offfarm were 3.12 (AOR=3.12 95%CI 1.3, 4.53), Children who had diarrheal before two weeks of the study 2.32(AOR=2.32 95% CI 1.76, 8.92) and maternal occupation who Were other than house wife 2.27 (AOR=2.27 95%CI 0.74-3.87) are significantly associated variable with severe acute malnutrition. CONCLUSION AND RECOMMANDATION The prevalence of severe acute malnutrition is relatively similar with Amhara regional state. Diarrhea disease of children before two week, source of food in off farm for the households and low monthly income determinant factors for sever acute malnutrition. RECOMMANDATION: Strengthen the implementation of childhood diarrheal management and, promote on source of food from on farm activities and means of food source diversification on farm activities in the woreda for improving socio economic of the community.