Sorghum (Sorghum bicolor) has a crucial role in the livelihoods and nutrition of many rural households in Ethiopia. Mycotoxin contamination is a major challenge affecting the quality and safety of stored grains. The objective of this study was to evaluate farmers' knowledge and management of sorghum mycotoxin contamination in Dejen District, North East Ethiopia. A cross-sectional survey design was used to assess farmers' knowledge and management of mycotoxin contamination in stored sorghum. Data were collected by using semi-structured questionnaires. Bi-variate and multi-variate binary logistic regression analyses were conducted to identify factors associated with farmers' knowledge and management practices. Data analysis was conducted with SPSS version 23. The study revealed that a significant proportion of farmers in the study area lack adequate knowledge (29%) and practices (40.57%) to mitigate mycotoxin contamination. In stored grain, only 6% of the farmers had information about fungi, yeasts, and their growth in foods and their harmful effects. Similarly, 2% of the respondents knew that molds are harmful to humans and animals. Only 5% of the farmers applied preventive measures to reduce mycotoxin contamination in stored grains. The results of this study showed that village location and educational status were significant predictors of knowledge, while age, village location, and educational status were significant predictors of management skills. Village location (Layamba: AOR 0.082, 95% CI 0.012-0.572) and educational status (secondary education: AOR 5.075, 95% CI 1.511-21.537) significantly predicted knowledge. Age (22-35 years: AOR 3.414, 95% CI 1.352-8.620), village (Ambayamit: AOR 0.149, 95% CI 0.028-0.796), and education (secondary: AOR 14.105, 95% CI 2.905-68.475) influenced management practices. Targeted interventions addressing geographic and educational disparities are essential to enhance awareness and practices, ensuring food safety. Targeted interventions actions are needed to improve farmers' awareness and management practices. Policy interventions are needed to address knowledge and practice gaps in mycotoxin contamination management. These interventions should target specific groups based on age, geographic location, and education status to mitigate mycotoxin contamination and improve food safety.