Background: A womenâ€˜s health is critical to her own life, and to the well-being of her family andrnthe economy of her community and her country. About 99% of maternal deaths occur in developingrncountries. Yet, most of these deaths could be avoided, if preventive measures were taken andrnadequate care was made. rnObjective: To assess factors affecting utilization of institutional delivery service among childrnbearing age women in Hadiyya zone SNNPR. rnMethodology: A cross sectional quantitative study was conducted among women who gave birthrnwith in the last three years preceding the survey in Hadiyya zone, SNNPR. Concerning to samplingrnprocedure a cluster sampling method was used to reach the eligible women in the randomly selectedrnstudy area. Data was collected by interview administered semi-structured questionnaire by trainedrnHEWs who able to speak local language. Data was entered at Epinfo version 3.4 software andrnexported to SPSS software version 16 for analyses. rnResult: A total of 414 women who had given at least one birth in the preceding three years beforernthe survey were interviewed giving response rate of 98.8%. Even though majority of the mothersrn(86.2%) received ANC, only 24.6% of them delivered at health facilities and the rest (76.4%)rndelivered at home with the help of relatives or TBAs which revealed gap between ANC and deliveryrncare utilization. The multivariate analysis revealed that women's residences, educational status, age,rnknowledge of danger signs, ANC frequency, and satisfactory attitude to institutional delivery were rnthe major factors that affect maternal utilization of institutional delivery. rnConclusion and recommendation: Findings of this study demonstrated that utilization ofrninstitutional delivery care among child bearing age women in Hadiyya zone is low. So promotion ofrnmaternal education, antenatal care, information education and communication on obstetric risks andrngeneral health service expansion were recommended