Background <p>Dietary diversity is critical not only for safeguarding against malnutrition but also for boosting child development. In Egypt, economic barriers pose the greatest challenge to food security, complicated by increasing food prices and a drastic reduction in livelihood opportunities. This study has two main objectives; First: Investigate household dietary diversity among families with children under 5 and to identify the key determinants of achieving acceptable dietary diversity within such households. Second: Examine food insecurity among children under 5 (6–59 months) and study the main factors affecting their food insecurity.</p> Methods <p>A secondary analysis of households with children under 5 was performed using Egypt’s 2018 Household Income, Expenditure and Consumption Survey (HIECS) data. Multivariate analysis included significant variables from the bivariate analysis. Binary logistic regression was used to identify covariates of dietary diversity.</p> Results <p>Regarding food insecurity among children under 5 (6–59 months), the data shows that only 30% of children aged 6–23 months consumed egg and meat products and 24% consumed legumes at most once weekly. The consumption of children aged 24–59 months in households with acceptable dietary diversity was almost twice that of those in households with unacceptable dietary diversity. Concerning household dietary diversity, the data shows that poverty, living in metropolitan areas and Upper Egypt, and household heads with temporary jobs were drivers of unacceptable dietary diversity among households with children under 5 in urban areas. In addition, lack of consumption of the household’s agricultural produce was associated with unacceptable dietary diversity in rural areas.</p> Conclusion <p>Poverty is the key factor associated with unacceptable dietary diversity in both urban and rural Egypt.</p>