BACKGROUND: Severe acute malnutrition is a major public health issue. It affects an estimated 8.1 million under–five children in India . Nearly 0.6 million deaths and 24.6 million disability adjusted life years are attributed to this condition. Diarrhea and pneumonia account for approximately half the under–five deaths in India and malnutrition is believed to contribute to 61% of diarrheal deaths and 53% pneumonia deaths . India is at the epicenter of this crisis despite the country’s recent economic growth. Strong scientific evidence exists on synergism between under nutrition and child mortality due to common childhood morbidities including diarrhea, acute respiratory infections, malaria and measles. In severe acute malnutrition, the case fatality rates related to these morbidities are excessively high. The aim of our study was to describe various risk factors responsible for severe acute malnutrition in children from 6 –59 months of age. Methods: The present study was conducted in the Post Graduate Department of Pediatrics, SMGS Hospital, Government Medical College, and Jammu on children of either gender from 6–59 months of age admitted in hospital from 1 November 2013 to 31 October 2014.A total of 120 children were taken up for study. Out of these 57 children had weight for height/length above –2 SD/Z score of WHO growth standards. These were taken as controls. Rest 63 children with inclusive criteria like weight for height/length <–3 SD/Z, visible severe wasting, presence of bipedal edema and /or mid upper arm circumference <11.5 cm were categorized under severe acute malnutrition cases and studied. Results: out of 120 children 63 (52.50%) had severe acute malnutrition and 57 (47.5%) were taken as controls. Most cases were seen in age group 12–18 months 20 (31.75%) followed by 18–24 months 10 (15.87%). In controls most were in age group 18–24 months 20 (35.09%) followed by 12 –18 months 10 (17.54%). In total study males were 63 (52.50%) and females 57 (47.50%). Among cases 43 were males (68.25%) and 21 females (31.75%) and in controls 20 were males (35.09%) and 37 females (64.91%). Marasmic–Kwashiorkar were 31 (49.21%) followed by marasmic 22 (34.92%) followed by kwashiorkor 10 (15.87%). Variables found to be significant risk factors and co–morbidities for severe acute malnutrition include mother illiterate in 77.77% cases, father illiterate 58.25% , father labourer or unemployed in 68.255 caeses, large family > 5 siblings 93.65%, household income < Rs 200/day in 52.385 cases, birth order >3 35.09%, low birth weight 76.19%, lack of breastfeeding 82.53%, deprivation of colostrums 60.32%, received prelacteal feeds 74.6%, breastfeeding < 9 months 49.2%,put to breast after 1 hour in 79.84%, improper dilution 55.88%, incomplete vaccination in 60.38% cases, drug addiction in 12.69% cases. Conclusion:We infer that preventive measures against the above mentioned significant risk factors associated with severe acute malnutrition would go a long way in reducing the severe acute malnutrition and in turn the morbidity and mortality of severe acute malnutrition.