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Hiwot Yisak,1 Rishah Elmneh,2 Wubet Taklual,1 Amien Ewunetei,3 Belayneh Kefale4 1Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia; 2Department of Supply Chain, Distribution and Sales, Julphar Pharmaceuticals Plc, Addis Ababa, Ethiopia; 3Department of Pharmacology, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia; 4Department of Clinical Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, EthiopiaCorrespondence: Hiwot YisakDepartment of Public Health, College of Health Sciences, Debre Tabor University, PO Box 272, Debre Tabor, Amhara, EthiopiaTel +251 913728949Email hyisak@yahoo.comBackground: Globally, pre-school children are the most at-risk population groups for vitamin A deficiency (VAD). The 2009 World Health Organization (WHO) report stated that one-third (190 million) of pre-school children worldwide are deficient in vitamin A. Both clinical and subclinical VAD have been a long-standing problem in developing countries. In Ethiopia, VAD was recognized as a public health problem 4– 5 decades before. Since then, researches conducted in other parts of the country still showed varied and high prevalence, which is 2– 8 times higher than WHO cut-off points. This community-based study was therefore conducted on pre-school children of rural kebeles in Farta district to determine the prevalence of clinical VAD (Bitot’s spot and night blindness) and associated factors.Methods: A community-based cross-sectional mixed quantitative and qualitative study was conducted. Randomly selected 588 pre-school children participated in the study. The clinical aspect of the study investigated the presence of Bitot’s spots on the children’s eye with the aid of a magnifying loop and torch. Data on the history of night blindness were obtained from mothers/caregivers by using WHO standard questions. The qualitative study data were obtained via a key informant interview with the mothers/caregivers whose child has clinical VAD. Quantitative data were entered using Epi Data statistical software and analysed by using SPSS version 20 statistical software package. A bivariable logistic regression was employed, and variables that showed significant association with clinical VAD (P < 0.2) were entered a multivariable logistic regression model to identify independent predictors of clinical VAD.Results: The prevalence of Bitot’s spot and night blindness was 0.8% and 1.2%, respectively. Pre-school children who were from highland (AOR: 3.71; 95% CI: 1.01– 13.68), a mother having antenatal care (ANC) visit during pregnancy of a child (AOR: 8.63; 95% CI: 2.58– 28.79), family monthly income (AOR: 8.63; 95% CI: 2.58– 28.79) and handwashing frequency were found to be determinants of VAD (p < 0.05).Conclusion: Clinical vitamin A deficiency in the study area is of public health concern because the prevalence of Bitot’s and night blindness was above the WHO threshold level. Accordingly, effective preventive measures should be designed to reduce VAD prevalence.Keywords: clinical vitamin A deficiency, Bitot’s spots, night blindness, Farta district