Background Undernutrition refers to micro or macronutrient deficiencies, leading to insufficient food intake and often resulting in stunting, wasting, underweight status or disease (UNICEF 2006). Undernutrition in children under five is a problem that disproportionately affects low-income countries. In Tanzania, the overall prevalence of stunting was found to be 34.7% (Tanzania Food and Nutrition Centre 2014). Great disparities exist within the Kilimanjaro region, as rural areas suffer greater prevalence of undernutrition than urban areas due in part to access to care (Tanzania Food and Nutrition Centre 2014). Objective To understand the policy and stakeholder perspective of undernutrition in children under five in Moshi Rural District Methodology A case study design that employed qualitative methods was used. Key stakeholders were identified using purposive and snowballing sampling technique. Data was collected using review of literature and stakeholder interviews. Data analysis was done using deductive thematic approach. This study focused on Moshi Rural, and interviews and research revolve around children under the age of five. Results A number of factors contribute to undernutrition in children. Importantly, nutrition as a low governmental priority leads to insufficient funding and medical resources to evaluate and integrate nutrition into the existing health system framework. Further, inadequacies in the health system lead to poor nutritional outreach, and management of undernutrition. Important stakeholders to consider in the planning and assessment of nutritional policies include: international organizations such as WHO and UNICEF that are tasked with research, planning and funding of nutritional interventions; the parliament and government, which writes and enforces policy at all levels of legislature; health practitioners who are service deliverers, and individuals who are ultimately receiving services, among a few other players. Conclusion Policies and stakeholders are inter-dependent on each other and have a big impact on children’s nutritional status. Both need to be well engaged to bring about a positive change.