<p><strong>Background:</strong> Malnutrition is a major global health problem, particularly affecting children under five years of age. In Ethiopia’s Tigray region, severe acute malnutrition contributes significantly to children morbidity and mortality. This study analyzed severe acute malnutrition trends, screening coverage and treatment outcomes among children under five in Tigray from 2015 to 2020, using secondary data from the health management information system to guide future health interventions.</p>