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Introduction Excessive screen time has emerged as a significant concern, particularly among children, due to its potential impact on physical and mental health. Excessive usage and its underlying determinants among children under five in Bangladesh have not been explored yet. This study aimed to find the prevalence of excessive screen time and its determinants among under-five children in Bangladesh. Research design and methods A cross-sectional study was conducted among children under the age of five in selected hospitals in Bangladesh. Conveniently selected parents of the children attending the outpatient departments of five hospitals were interviewed. Previously used validated semi-structured questionnaires were used for the study. The independent variable included socio-economic factors, home media environment, and parental attitudes toward screens. A binary logistic regression was performed to ascertain the determinants of excessive screen time. Results The prevalence of excessive screen time was 85.8%. Urban residence (aOR: 1.861, 95% CI: 1.003–3.454; p  = 0.049), having television (aOR: 2.003, 95% CI: 1.077–3.726; p  = 0.028), mobile with internet (aOR: 3.237, 95% CI: 1.574–6.576; p  = 0.001), and parent’s knowledge on more than one hour screen time (aOR: 2.320, 95% CI: 1.186–4.525; p  = 0.014) were independent determinants of excessive screen time. Conclusion Excessive screen time was high among under five children. Urban residents, having television, mobile with internet, and parents’ knowledge were found to be associated with this excessive screen time. Targeted interventions should focus on educating parents about appropriate screen time limits, especially in urban areas and households with easy access to digital devices.