Background <p>Micronutrient deficiency remains a major public health problem among children in developing countries. Universal multiple micronutrient supplementation is one strategy to prevent these deficiencies. Here, we aim to describe the usage and acceptability among infants and the knowledge and perception among mothers regarding universal micronutrient supplementation in a suburban area of Sri Lanka.</p> Methods <p>This cross-sectional study was conducted in Kurunegala district of Sri Lanka from June to August 2022. Infants aged between 9 and 12 months attending the well-baby clinics of four Medical Officers of Health areas were recruited after obtaining informed written consent from their mothers. Data were collected using an interviewer-administered questionnaire that included questions on maternal knowledge, perceptions, and practices regarding micronutrient supplementation. Data were analysed using the chi-square test. Ethical approval was obtained from the Sri Lanka College of Paediatricians.</p> Results <p>A total of 395 mothers participated. The mean age of the infants of participating mothers was 10.3 ± 1.1 months. All infants had received micronutrient supplements; however, only 58% used the recommended dosage (7 sachets per week), and 37% used &lt; 4 sachets per week. A majority (56.5%) stated that food acceptability was lower when micronutrient supplements were mixed. 76% and 44% mothers, respectively, reported that the addition of micronutrient supplements introduced a bad taste and smell to the food. All mothers were aware of the daily dosage and the method of mixing micronutrient supplements with food. However, only 55% were aware of the recommended duration of supplementation. A majority (95%) of mothers perceived micronutrient supplements as beneficial, and 55% found the micronutrient preparations easy to use. A significantly higher proportion of mothers in skilled or professional employments had good knowledge of multiple micronutrient supplementation than mothers who were unemployed or in unskilled occupations.</p> Conclusions <p>The supply of micronutrient supplements has been regular in the Kurunegala district during the study period. However, acceptability was low, at least partly due to changes in food taste and smell after adding micronutrient supplements. The low acceptance is likely due to factors intrinsic to the micronutrient preparations, which need to be rectified in the future.</p>