With expansion of access to education, more young people spend a reasonable time of their youthrnin schools. As a result, preparatory school students are among the fast growing segments ofrnadolescents in Ethiopia. Although this development has a positive impact on Sexual andrnReproductive Health (SRH) and the future of in-school adolescents, there are also factors thatrnincrease the SRH risks of this group. Lack of comprehensive knowledge of the risks, preventivernand protective methods and limited access to SRH services are said to be contributories to thernvulnerability of this group to SRH problems.rnThe general objective of this study was to assess the status of, and factors to SRH servicernavailability and utilization of preparatory students in rural/urban settings â€“ at Dangilla (AmhararnRegional State) and Menelik II (Addis Ababa) Preparatory Schools. A cross sectionalrncomparative study was undertaken among students enrolled in the two schools during thernacademic year 2009/2010. Quantitative and qualitative methods were deployed which appliedrnquestionnaires, interviews, Focus Group Discussion (FGDs), document reviews, andrnobservations. A total of 1068 randomly selected students (442 females and 626 males)rnparticipated in completion of the survey questionnaire. Twenty nine (29) purposively selectedrninformants were interviewed; eight (8) FGDs were separately conducted with female and malernstudents, teachers and parents; and relevant documents were reviewed.rnThe findings indicate that in-school adolescents in general and females in particular arernconsidered to be the most vulnerable groups to SRH problems. While most students have goodrnknowledge of key SRH issues such as about most commonly used contraceptive methods and HIVrntransmission methods, however, rural-urban and male-female disparity in some of the issues isrnobserved. Although female groups in most cases are at the same level, specifically in identifyingrnbasic transmission and prevention methods of HIV, misconceptions seem to be more prevalentrnamong female respondents from Dangilla. Discussion on SRH issues among family circles stillrnremains a taboo. In some cases SRH information and services are felt as unnecessarily available.rnAvailable RH services widely differ between the two study areas. In Addis, there are various typesrnof SRH services provided by many agencies whereas in Dangilla these are limited both in typernand providers. However, in-school SRH services, both curricular and co-curricular were more ofrnthe same and focus mainly on HIV/AIDS. Utilization of out of school healthcare services byrnadolescents is very limited. Some of the main factors that limit use of services were attributed to:rnlack of comprehensive knowledge and limited awareness on available services; concern overrnproviders and non-youth friendliness of services (privacy/confidentiality, preference for same-sex provider, and miscommunication); societal expectations and fear of stigma (cultural and religious norms and taboos), and economic. The role of these factors varies between sites and among groups.rnKey words: Addis Ababa, Dangilla, knowledge, schools, reproductive health, students,rnutilization