Soil-transmitted helminths (STH) (Ascaris lumbricoides, Trichuris trichiura and hookworm) are among the most prevalent neglected tropical diseases (NTDs) in Ethiopia. Pre-school age children (PSAC) pay high morbidity toll associated with STH infections. Site specific operational evidence is lacking on prevalence, intensity and control strategies of STH among PSAC in Ethiopia. This study is, therefore, aimed to fill that missing knowledge gap. Methods: We did a community-based cross-sectional

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... dy in five districts of Gamo Gofa zone; from December 2018 to January 2019. Data were collected using pre-tested questionnaire, and the Kato-Katz technique was used to diagnose parasites egg in stool. Then data were edited, coded and entered into EpiData 4.4.2, and exported to SPSS software (IBM, version 25) for analysis. Results: A total of 2462 PSAC participated in this study. Overall, the prevalence of STH was 23.5% (578/2462). Ascaris lumbricoides was the most prevalent, 18.6% (457/2462), followed by Trichuris trichiura, 9.2% (226/2462), and hookworm, 3.1% (76/2462). The prevalence of STH in Chencha, Dita, Deremalo, Bonke and Demba Gofa districts were 33.8% (210/622), 26.4% (109/413), 21.3% (88/414), 20.6% (128/621), and 11% (43/392), respectively. Of the total, 7.4% (181/2462) PSAC were infected with two STH species. Ascaris lumbricodes infections had moderate intensity (15%), and the rest had low infections intensity. It is found that 68.7% of PSAC were treated with Albendazole. This study also revealed households level data as, 39.4% used water from hand-dug well, 52.5% of need to move ≥30minutes to collect water, 77.5% did not treat water, and 48.9% not had hand washing facility. Conclusion: This study showed that a significant proportion of pre-school age children are suffering from STH infections across districts in the study area despite preventive chemotherapy distribution for more than 10 years. Further, gaps in control strategies of STH were highlighted, which calls for action.