Abstract Background: The morbidity and mortality related to diarrheal diseases in under-5 children are still persistent in low income countries, especially in sub-Saharan Africa including Ethiopia. Objective: To assess the prevalence and determinant of diarrhea among children under five years of age among in the rural community of Yilmanadensa district, West Gojjam zone North West Ethiopia, 2017. Methods: A community based comparative cross-sectional study design was applied in model HH and non-model HH of in the rural community of Yilmanadensadistrict. A total of 675study participants (337model HH and 338non-model HH) mothers of the index under-five children living in the households were selected randomly from nine kebeles in rural community of the district. Face to face interviewer administered questionnaire and observational cheek list were used. Collected data were entered in Epi Info 7 and analyzed using SPSS version21. Descriptive statistics like frequency, percentage, mean, standard deviation was calculated. Logistic regression analysis was employed to identify factors. Results: The prevalence of two weeks’ diarrhea on under five children were 57(16.9%) and 99(29.3%) in model HH and non-model HH respectively. Hand washing practice at critical time (AOR=2.55, 95%CI: 1.02, 6.17) and children feeding practice (AOR=1.94, 95% CI: 1.06, 3.55) were predictors of diarrhea in model HH. Maternal diarrheal history in the past two weeks (AOR=3.34, 95%CL: 1.51, 7.41), house shared with domestic animals (AOR=1.79, 95%CI: 1.04, 3.03), supplementary feeding time (AOR=2.29, 95%CI: 1.29, 4.07) and child stool disposal methods (AOR=2, 65, 95% CI: 1.14, 6.15) were significantly associated with diarrhea occurrence in non-mode HHS. Conclusion and Recommendation: Under five children from non-model HH 1.65 times were more likely to develop diarrhea compared to children from model HH but the prevalence of two weeks’ diarrhea both model HHS and non-model HHS were relatively high. Health education should be provided strongly to adopt positive behavior or practice at the HH or at the community level to reduce under five children diarrhea. Keywords: Model HHS, diarrhea, children, Yilmanadensa district