Background Undernutrition is a significant challenge for adolescent girls globally due to biological, social, and cultural factors. The consequences of undernutrition for adolescent girls are extensive, impacting their cognitive abilities, reproductive health, susceptibility to chronic diseases in later life, and the economies of nations. However, there needs to be a more comprehensive understanding of the nutritional status of adolescent girls in the Diga district, Ethiopia. Objective This study aimed to assess the prevalence of undernutrition and its associated factors among adolescent girls in the Diga District, East Wollega Zone, Ethiopia. Methods The study employed a community-based cross-sectional study design in Diga District, Ethiopia. Data was gathered from 651 study participants using a systematic random sampling technique, from July 10th to August 10th, 2023. Data analysis involved using Epi-Data 4.6 and SPSS version 26 for data entry and statistical analysis, respectively. The Body Mass Index (BMI) and Height-for-age (HFA) Z-score are generated using WHO AnthroPlus version 1.0.4 software. Descriptive statistics and binary logistic regressions were used for data summarization and analysis, with significance testing at a p-value <0.05. Results In this study, 16.3% (95% CI: 13.5–19.3) of adolescent girls were stunted, while 18.5% (95% CI: 15.4–21.5) were thin. Lack of access to health and nutrition information (AOR = 3.36, 95% CI: 1.38–8.23), limited crop variety within household’s crops (AOR = 1.66, 95% CI: 1.03–2.65), and household food insecurity (AOR = 2.76, 95% CI: 1.49–5.11) were factors associated with stunting. Poor dietary diversity scores (AOR = 7.52, 95% 95% CI: 2.92–19.39) and household food insecurity (AOR = 3.69, 95% CI: 1.96–6.93) were significantly associated with thinness. Conclusion Conclusively, there was a low prevalence of stunting and thinness among adolescent girls in the Diga district, Ethiopia. Interventions aimed at enhancing household-level crop diversity, improving food security, providing adequate health and nutrition information, and promoting income-generating activities for adolescent girls can play a crucial role in improving their access to nutritious foods and healthcare, ultimately leading to better nutritional outcomes.
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