Background: Malnutrition in school-age children significantly affects their health, cognitive development, and educational attainment. This study aimed to assess the nutritional status of school-age children and the influence of socioeconomic, demographic, and environmental factors on their nutritional well-being. This study focused on primary focus was on primary school children in Dodoma. sought to identify children who could be at risk of malnutrition. The study intended to establish baseline data regarding the nutritional status of school children that could contribute to a comprehensive understanding of the nutritional landscape among primary school children in the region. This information could subsequently inform nutritionists and policymakers to plan interventions to improve these children's nutritional status. Methods: A cross-sectional study involving 248 pupils was conducted in eight primary schools in Dodoma. Four schools were selected from Chamwino and Dodoma urban districts, respectively, whereby two government schools and two private schools were selected from each district. The other four schools were situated in the urban district of Dodoma, comprising two government and two private schools. The study assessed the prevalence of stunting, wasting/thinness, underweight, and overweight/obesity among primary school children. Stunting was characterized by impaired growth and development with low height for age, while underweight was defined as low weight relative to age. Wasting/thinness refers to insufficient flesh, with body weight falling below skeletal and physical standards. Overweight/obese indicates excessive fat tissue accumulation that could impact health. Data were analyzed using the WHO AnthroPlus v1.0.4 software and SPSS v26 software for Windows. Results: Prevalence rates among the surveyed pupils were as follows: stunting (10.5%), underweight (3.6%), thinness (2.8%), and overweight/obesity (10.1%). Stunting was more prevalent in boys (13.2%) than in girls (8.2%), and it exhibited an upward trend with increasing age. The prevalence of underweight was higher in public schools (8.2%) compared to private schools (3.2%). Thinness was more common in public schools (85.7%) compared to private schools (14.3%) and was more prevalent in rural areas (57.1%) and among younger children (57.1%). Overweight/obesity was more prevalent among girls (91.0%) compared to boys (88.6%). Schools in urban areas showed a higher prevalence of overweight/obesity (90.3%) than those in rural areas (89.5%). Private schools (95.2%) had a higher prevalence of overweight/obese pupils compared to public schools (84.7%). Pupils residing in urban areas were more likely to become overweight/obese compared to their counterparts living in rural settings. Conclusion: Significant rates of stunting, thinness, underweight, and overweight/obesity were observed among primary schoolchildren in Dodoma, Tanzania. These findings underlined the necessity to enhance nutrition interventions to improve the nutritional status of both public and private primary school pupils in Tanzania.