<p>Administering regular doses of Vitamin A to eligible children is a vital nutritional strategy in regions where Vitamin A deficiency is a concern. Despite the importance of VAS, the extent of its coverage and the factors influencing its uptake have not been extensively researched in the study area. This community-based cross-sectional study was conducted in Fitche Town, central Ethiopia, involving 420 children aged 6–59 months. Systematic random sampling was employed to gather data through a pretested questionnaire administered to mothers and caregivers. The questioners covered socio-economic and demographic characteristics, knowledge of vitamin A, health service utilization, and VAS distribution strategies. The data analysis was performed using SPSS Version 25, with logistic regression used to evaluate the associations between various factors and VAS uptake. Adjusted Odds Ratios (AOR) with a 95% Confidence Interval (CI) were also calculated to assess the strength of these associations. The study found that only 62.7% of children in the study area received VAS, indicating a significant gap in coverage. Factors significantly associated with higher VAS uptake included postnatal care visits (AOR = 2.1), maternal nutritional counseling (AOR = 2.7), measles vaccination (AOR = 2.5), knowledge of VAS and related issues (AOR = 2.6), and frequent antenatal care visits (≥ 4 visits) (AOR = 3.2). The results highlighted the uptake of VAS in the study area was suboptimal compared to the WHO’s recommended rate of 80%. This indicate the need for targeted interventions aimed at improving maternal education and healthcare utilization to boost VAS uptake. Concerted efforts from health workers, healthcare institutions, and non-governmental organizations are essential to raise awareness of VAS. Emphasizing the importance of postnatal care visits, maternal nutritional counseling, measles vaccination, and regular antenatal care visits in promoting VAS uptake is vital.</p>