Background <p>Birth registration is not only a fundamental right of a child but also a key social determinant of health. It provides legal identity for access to health services, immunization, and protection from violence and exploitation. Despite Bangladesh’s legislative commitment, which mandates registration within 45 days of birth, 43.67% of children are still unregistered. This gap makes it difficult to achieve health coverage, child protection goals, and the target of ensuring identity for all by 2030.</p> Methods <p>This study used the Bangladesh Multiple Indicator Cluster Survey 2019 and conducted a multiple logistic regression analysis to examine the predictors of birth registration in Bangladesh. All analyses accounted for the complex survey design of MICS 2019 using sampling weights, stratification, and clustering.</p> Results <p>This study found a strong positive age gradient, with children of age four having significantly higher odds of registration compared to infants (OR = 3.34, 95% CI = 3.04–3.70). Children of mothers with higher secondary education had 37% (OR = 1.37, 95% CI = 1.17–1.59) higher odds of registration compared to those with no education. Children from the richer wealth quintile had 21% (OR = 1.21, 95% CI = 1.06–1.37) higher odds of being registered compared to the poorest households. Significant regional disparities were observed, with the Sylhet division showing the highest odds. However, ethnicity and sex had no significant association with birth registration.</p> Conclusion <p>Policy efforts must prioritize mothers with no formal education and the poorest households through targeted awareness and financial incentives. Furthermore, region-specific strategies are essential to address administrative barriers in low-performing divisions to ensure equitable health and social services for children.</p>