Background: Skilled attendant for every pregnant woman during childbirth is the most criticalrnintervention for improving maternal and child health. Evidence showed that the majority ofrnbirths are delivered at home and the proportion of deliveries assisted by skilled birth attendant isrnvery low. Every day, at least 1,600 women die worldwide from the complications of pregnancyrnand childbirth, 90% of which occurring in Asia and sub-Saharan Africa. Maternal mortality raternwas shown to have the largest discrepancy between developed and developing countries. Arnlifetime risk of maternal death in developing countries is forty times higher than that of therndeveloped world. In Ethiopia, maternal and infant mortality and morbidity levels are among thernhighest in the world. Studies had clearly demonstrated that the utilization of existing maternalrnhealth services is very low in the country. Only a quarter of Ethiopian women received antenatalrncare (ANC) and less than 10 percent of mothers deliveries assisted by skilled birth attendant. rnObjective: To assess utilization of skilled birth attendant at delivery, among mothers who gavernbirth the past two year prior to the survey in yirgachefe town. rnMethods: A community based cross-sectional quantitative study method was conducted amongrnwomen residing in Yirgacheffe town. The study populations were randomly selected womenrnwho gave birth in the last two year in the town. After establishing the sampling frame of eachrnhousehold, systematic random sampling technique was used to identify the list of households inrneach kebeleâ€™s to reach to 440 women included in the survey. Data was collected using adaptedrninterviewee administered Amharic version questionnaires and data analyzed using SPSS versionrn16. A different proportion was computed and crude and adjusted Odds ratios and confidencernintervals were performed for the association between variables and stepwise multiple logisticrnregressions were used to identify factors that affect utilization of skilled birth attendant. rnResult: A total of 440 women were included in the study. 58.9% of the women utilize skilledrnbirth attendant during delivery. Reasons given for home delivery includes, feeling of more rncomfortable just being at home, usual practice, close attention from relatives & family members,rnshort and smooth labor, to exercise cultural values, not liking health facility due to badrnexperience, unwelcoming approach of health workers and other reasons. Births to women withrnprimary education are two times more likely (OR=2.3 and 95% CI=1.24-4.2), and births tornwomen with secondary and above education are four times more likely (OR=3.6 andrn95%CI=1.5-8.4) to utilize SDA as compared to illiterate women. Women who are Governmental rnemployee were four times more likely to utilize SDA than those who had private bissnussrn(OR=3.6 and 95%CI=1.5-8.4). Women with one and two to four pregnancies and births werernthree and two times more likely utilize SDA than women who have >=5 pregnancies and birthsrn(OR=2.6, 95% CI= 1.17 to 4.45) and (OR=2.3, 95% CI=1.41 to 4.65) respectively. Women whornhave ANC visits (,OR=16.7 and (95%CI= 8.2, 33.89), more likely utilized SDA than who did notrnvisit. Preference of the respondentâ€™s husbands and families, those who prefer delivery withrnhealth professional were four times and five times more likely to utilize skilled delivery attendantrnas compared with those, their husbands and families prefer delivery without health professionalrn(TTBA,TBA and family and relatives) OR= 4.03 (95%CI=1.37 to 11.8),OR=4.6,95%CI=1.5 torn13.9) respectively. rnConclusion: The study finding revealed that utilization of SDA was more than half, still there isrna gap between users and providers and those are interrelated to each other. Consequently, rnCommunity members should be discouraged harmful traditional and usual practices that hinderrnhealth facility delivery care utilization. Incourage favourable influences from their husbands andrnrelatives about their delivery practices, women empowerment, promotion of maternal education,rnprenatal care utilization, communication on obstetric risks and general health service expansionrnwere recommended.