Introduction: Stunting is a height-for-age (Z-score) less than minus two standard deviations below the mean of the reference standard. It is the most important sign of long-term chronic undernutrition and a public health problem in Ethiopia. Even though stunting in adolescents reflects poor nutrition, infection, and environmental stress, identifying determinants of stunting is still not well addressed in the semi-urban and rural areas of the country. Objective: To identify determinants of stunting among adolescent girls in schools of Digo Tsion Town, Northwest Ethiopia, 2022. Methods and materials: Unmatched case-control study was conducted among 417 adolescent girls (104 cases and 313 controls) in schools of Digo Tsion Town from May 13 to June 13, 2022. Computer generated simple random sampling was employed. Stadiometer and World Health Organization Anthroplus 2007 software were used for screening. A structured interviewer- administered questionnaire was used. The data was collected by epicollect5 mobile application through a fac-to-face interview. The data was entered in epi data 4.6 and exported into Statistical Package for Social Science version 26. Variables with p- value ≤ 0.25 in bivariable analysis were candidate for multivariable analysis. Model fitness was checked by Hosmer and Lemon show fitness of test. Variables having a P-value < 0.05 in multivariable analysis were declared as statistically significant at 95% Cl. The result was presented by a statement, figures, and tables. Results: A total of 409 adolescent girls (100 cases and 309 controls) participated, with a response rate of 96% for cases and 98.72% for controls. Food insecurity (AOR = 2.13, CI [1.15, 3.93]), low dietary diversity score (AOR = 1.99, CI [1.06, 3.73]), drinking coffee/tea immediately while eating meals (AOR = 2.19, CI [1.22, 3.95]), not getting nutritional counsel (AOR = 2.07, CI [1.17, 3.66]), chronic illness (AOR = 3.78, CI [1.16, 12.3]), and not visited by health extension workers at home (AOR = 1.85, CI [1.03, 3.31]) were statistically significant determinants of stunting. Conclusion and recommendation: Stunting was significantly influenced by a low dietary diversity score, a food insecure household, drinking coffee/tea immediately while eating a meal, not receiving nutritional counseling, having chronic illness, and not being visited by health extension workers. Parents/guardians, adolescent girls, school communities, health care professionals, and concerned organizations better to work on factors of this study finding. Key words: Stunting, Adolescent girl, Determinant, Digo Tsion