Childhood undernutrition is a foremost worldwide health issue and may lead to severe acute malnutrition (SAM) backing to upraised risk of co-morbidities and mortality in the children due to reasonably defective immunity.There is lack of data concerning collective outcomes in SAM so this study was done to identify the co-morbidities in SAM children. Material and Methods-This study was a hospital-based descriptive type observational study done on the children of age group 6months-5years, diagnosed with SAM based on WHO criteria in a tertiary care hospital in Azamgarh, UP over a span of a year. Result-Major clinical co-morbidities associated with SAM children found to be diarrhoea and acute respiratory tract infections (ARTI) and two major micronutrient deficiencies were Anaemia and vitamin D deficiency. Conclusion- Mortality in SAM highly depends on the co-morbidities and socio-demographic status of the SAM children so educating people regarding risk factors and timely diagnosis of the related co-morbidities can ensure appropriate treatment and better prognosis of the disease.