Currently, peer pressure has become a concern for many secondary andrnpreparatory school students as well as parents in Ethiopia. It is becomingrnthe biggest factor in determining whether the secondaryand preparatoryrnschool students use cigarettes, alcohol, Khat and other substances; lowrninvolvement in education and engage in sexual activities or not. The majorrnobjectives of the study were to examine the extent of peer pressure, comparernthe extent of peer pressure between male and female secondary andrnpreparatoryschool students, and to identify factors associated with peerrnpressure among secondary and preparatoryschool students. Mixed researchrnapproach was employed in this study.The study generated the required datarnfrom a representative sample of 402 adolescent students drawn from thernstudy population through multistage sampling. Data were collected throughrnquestionnaire and focus group discussion. Analysis was done using simplerndescriptive statistics, chi-square and linear regression.According to thernfinding in this study, 94(23.4%) of adolescent students are under negativernpeer pressure. Though, the chi-square test indicated that there is nornsignificant difference on the extent of peer pressure on both sexes, thernpercentage of male (24.9%) is greater comparing to females (22.2%). Therernis strong association between peer pressure and substance use (ï£2rn3=178.1,rnP < 0.05 for khat, ï£2rn3=171.7, P < 0.05 for tobacco, ï£2rn3 =168.53, P < 0.05rnfor alcohol and ï£2rn3 =156.92, P < 0.05 for other substance); sexual activitiesrn(ï£2rn1= 199.12, P < 0.05 starting sexual activity and ï£2rn2= 128.34, P < 0.05rnfor having boy/girlfriend); and communication with family (ï£2rn3 =179.1, P