A cross-sectional community-based comparative study was conducted to assess knowledge and rnpractices of birth preparedness and complication readiness and factors associated with their rnpractices among women who gave birth in the last 12 months preceding the survey in Hawassa rncity, SNNPR, Ethiopia. The study was undertaken between October 2010 to April 2011 pre rntested structured questionnaire was used to obtain relevant information. Data were obtained from rn550 mothers. Including both unprompted and prompted responses, 85.6% of the respondents rnmentioned identifying place of delivery, 90.4% mentioned saving money, 45.5% mentioned rnidentifying skilled provider and 81.8%mentioned identifying a mode of transportation as rnelements of birth preparedness. Two hundred twenty two (40.4%) of the respondents reported rnthat they identified place of delivery, saved money and identified a mode of transport ahead of rnchildbirth. In multivariate analysis birth preparedness was higher among literate mothers (OR= rn2.41, 95% CI= 1.97,4.37), women who have a good income (OR=3.28, 95% CI= 1.91,5.64), rnwomen with history of still birth (OR= 3.37, 95% CI= 1.47,7.75), having ANC follow up (OR= rn4.13, 95% CI= 1.33, 12.82)and awareness about BPCR (OR= 8.25,95% CI=4.47,15.22). About rn82.2% of the respondents gave birth by a skilled provider. Skilled provider at birth was higher rnamong those who were literate, with better income, first births, those who had ANC follow up rnand those who were birth prepared. The study identified poor comprehensive knowledge and rnpractices of birth preparedness in general and very poor knowledge on danger signs in particular. rnImprove the information given during ANC follow up, with special emphasis given to birth rnpreparedness in general and information on obstetric danger sign in particular, community rneducation about birth preparedness, particularly about danger signs, empowerment of women, rnimproving the information given during the ANC follow up with are recommended.