Introduction: this study aimed to determine the factors of the underutilization of the insecticide-treated mosquito nets in Mususa Commune so as to guide health authorities in planning health education. Methods: it was about a cross-sectional study, conducted from April 2nd to May 6th, 2015 on 400 heads of households of MususaCommune. Results: A rate of use of mosquito nets impregnated with insecticide of 62.25% was observed. The female sex (RR:0.67; 95% CI:0.53-0.85) , ITN protects against rats (RR:0.21;95% CI:0.06-0.76), use of mosquito nets impregnated with insecticide not required (RR 0.47 ; 95% CI : 0.24-0.92), water as a vehicle for malaria (RR: 0.67; 95% CI: 0.49-0.91), use of turns (RR:0.59; 95% CI: 0.35-0.99) are the factors associated with the underutilization of insecticide-treated mosquito nets in Mususa commune. Conclusion: The good use of insecticide-treated mosquito nets is an effective way to reduce the incidence of malaria in Butembo.