Aim: This study aimed to examine the relationship between transcultural factors with health care seeking behavior of families of under-five children with ARI in Lhokseumawe. Methods: quantitative approach with a cross sectional study was conducted. The population in this study was all mothers who have children (1 - 5 years) who suffer from ARI. The number of samples in this study was determined by estimation, so as many as 321 mothers were participated. The research instrument consisted of 105 statement lists to measure transcultural variables. Data were analyzed by chi-square test and binary logistic regression with the stepwise method. Results : The results showed that out of 7 transcultural variables, There were 4 variables ; technological factor (P-value: 0.037), religious and philosophical factor (P-value: 0.007), kinship and social factor (P-value: 0.002), cultural values, beliefs and ways of living factor (P-value: 0,0001) and educational factor (P-value: 0,0001), Cultural values, beliefs and ways of living and educational factors are the most dominant predictors influencing health care seeking behavior in families of children under five with ARI. Conclusions: Cultural values, beliefs and ways of living and educational factors are the most dominant predictors of health care seeking behavior in families of children with ARI.