Ill-thrift or poor growth in small ruminants is a global concern for both veterinarians and small ruminants' producers. The aim of this study was to assess the risk factors of ill-thrift and the associated clinicopathological changes. Smallholder farms were the source of 150 goats used in the study. Based on clinical findings and body condition score (BCS), the goats were classified into 3 groups: emaciated (BCS 1, n = 46), thin (BCS 1.5-2, n = 52), and control (BCS≥2.5, n = 52), respectively . Blood samples were used for clinicopathological investigations, and risk factors were tested. Goats suffering from emaciation had a significant decrease in haemoglobin (HGB) (P= 0.012), mean corpuscular haemoglobin (MCH) (P= 0.029), mean corpuscular haemoglobin concentration (MCHC) (P=0.03), albumin (P=0.009), sodium (Na) (P=0.039), iron (Fe) (P=0.004), copper (Cu) (P=0.022), and selenium (Se) (P= 0.027) compared to the control group. White blood cell count and globulin levels, on the other hand, were significantly elevated in the emaciated group (P= 0.0001, and P= 0.039, respectively). Goats aged ≤ 2 years (odds ratio (OR): 6.5, P = 0.0001), female goats (OR: 10.1, P = 0.0001), and those fed on unbalanced rations (OR: 13.3, P = 0.032) were at higher risk of ill-thrift. In conclusion, this study evidenced that ill-thrift is associated with significant alterations in the haematological and biochemical profiles. Young age, gender, and unbalanced rations are the potential risk factors for ill-thrift in goats. Recognition of risk factors associated with ill-thrift provides valuable insights for prevention and management programs.