Background: Orphans are potentially at greater risk of malnutrition because they are more likely to be extremely poor and receive less medical and social care. Children living in orphanages tend to be neglected and may be malnourished and they’re at risk of losing their full potential, with consequences to the child, nation and worldwide. Despite the nutritional concerns raised globally and in neighboring countries among these children, there exists an inadequate body of information about orphans’ nutritional status and feeding practices in Tanzania. This study aimed to assess the nutritional status, feeding practices and factors contributing to malnutrition among children aged 6 - 59 months in Arusha region orphanages, Tanzania. Study Objective: To assess the nutritional status, feeding practices and factors contributing to undernutrition among children aged 6 - 59 months in Arusha region orphanages, Tanzania. Methodology: This was an institution-based cross-sectional study conducted in selected orphanage Centre in the Arusha region. A representative sample size of 216 children aged 6 - 59 months in Arusha orphanages was selected to participate in the study. Multistaging sampling was used to select the study participants. Interviewer-administered questionnaires and anthropometric measurements were used during data collection. The data collected were entered, processed, and analyzed; continuous variables were summarized by use of mean and Standard deviation, while categorical variables were summarized by use of frequency, percentages and figures. Multivariable logistic regression was used to estimate the Odds Ratio with 95% CI and measure the strength of association between the outcomes with respect to selected independent variables. Variables with a p-value of less than 0.05 were considered statistically significant. Results: A total of 216 children from the orphanage Centre were involved in this study. Prevalence of Stunting, underweight and wasting among orphan children were 23.60%, 15.30% and 9.30%. The proportions of MDD and MMF were 89% and 99%. Children being on medication for any kind of illness during the survey (AOR: 7.9; 95% CI: 1.95, 31.78), unmarried caregivers (AOR: 1.9; 95% CI: 1.32, 10.86), fever 2 weeks before the survey (AOR: 2.9; 95% CI: 1.09, 9.24) and orphanage Centre with more than 30 children (AOR: 1.8; 95% CI: 1.08, 6.86) were found to be associated with undernutrition. Conclusion: In Arusha orphanages, the prevalence of stunting, underweight, and wasting among children
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