Relevance. Child malnutrition in Nigeria exhibits significant geographic variation, shaped by environmental, socio-economic, and demographic factors. Understanding this spatial multiplicity is central to designing targeted and effective interventions. Research objective. To identify and map geographic clusters ( hotspots and coldspots) of child malnutrition and to examine the factors influencing child malnutrition across senatorial districts in Nigeria. Data and methods. Using data from the 2018 Nigeria Demographic and Health Survey (NDHS), this study employed spatial autocorrelation and spatial regression models to examine the distribution and determinants of child malnutrition across 109 senatorial districts. Results. Findings reveal significant spatial clustering of undernutrition indicators such as stunting, underweight, and wasting, particularly in Northwestern and Northeastern states such as Sokoto, Zamfara, Kebbi, Yobe, Borno, and Kano. Conversely, lower malnutrition rates (cold spots) are observed in the Southwest, South-South, Southeast, and select North-Central districts. Positive Moran’s I value confirms spatial dependence in undernutrition, while overnutrition showed no such pattern. Key predictors include maternal education, maternal BMI, household size, maternal age, wealth index, Vitamin A supplementation, farm size, rainfall, and senatorial district area. Conclusions. The study highlights the critical role of geography in malnutrition outcomes, emphasising the identification of hotspots and cold spots as a basis for intervention. It underscores the need for district-specific policies that are spatially targeted, taking into account localised drivers of malnutrition, to enable more efficient resource allocation and improve nutritional outcomes.