BACKGROUND: Uvulectomy is a surgical procedure that involves the removal or excision of part of the uvula, the small, fleshy tissue that hangs down at the back of the throat. This procedure is traditionally practiced in various cultures, particularly among some African communities and in parts of the Middle East. While uvulectomy holds traditional significance in these contexts, its significance and cultural implications may vary across different regions and communities. Uvulectomy is performed only in rare cases for specific medical indications and carries an increased risk of side effects. Traditionally, families perform this procedure on their children without any medical indication, a practice passed down from previous generation. In contrast, the medical procedure is conducted under sterile condition by qualified professional when there is a valid indication. Understanding the factors associated with these practices is crucial for developing strategies to prevent adverse outcomes, especially in young children. OBJECTIVE: The objective of this study was to determine the prevalence and associated risk factors of uvulectomy in children less than two years of age in the Godere District of the Majang Zone, Gambella Region, Southwest Ethiopia. DESIGN: A community -based cross sectional survey was conducted from June 1 to June 30, 2022, involving 664 randomly selected participants. A standardized questionnaire in the Amharic language was utilized to collect data, which were subsequently entered into EpiData and analyzed using SPSS. Statistical significance was assessed, and logistic regression was performed to determine statistical significance at a p-value of less than 0.05, with a 95% confidence interval (CI). RESULT: The prevalence of traditional uvulectomy in children under 2 years of age was 61.9%. Being a rural resident [AOR = 2.3 (95% CI: 1.2-4.39)], lack of maternal education [AOR = 3.18 (95% CI: 1.33-7.6)], maternal awareness of harmful traditional practices [AOR = 2.09 (95% CI: 1.32-3.14)], the perception that the uvula causes illness [AOR = 0.14 (95% CI 0.09-0.21)], and receiving counseling on traditional uvulectomy during antenatal follow-up [AOR = 16.31 (95% CI: 4.25-62.51)] were factors identified as significant predictors of traditional uvulectomy. CONCLUSION: The research highlights the importance of addressing this widespread issue through targeted interventions and educational campaigns. Strategies should focus on increasing awareness among rural communities about the potential negative consequences of traditional uvula practice.