Background- Birth preparedness and complication readiness is a strategy to promote the timelyrnuse of skilled maternal and neonatal care, especially during childbirth. Based on the theory thatrnpreparing for childbirth, and being ready for complications reduces delays in obtaining this care.rnLack of advance planning for use of a skilled birth attendant for normal births, and particularlyrninadequate preparation for rapid action in the event of obstetric complications, are wellrndocumented factors contributing to delay in receiving skilled obstetric care. Birth preparednessrnhas been globally endorsed as an essential component of safe motherhood programs to reducerndelays for care, so reduced maternal mortality rate and neonatal mortality rate.rnObjective: To assess knowledge and practices with respect to birth preparedness andrncomplication readiness among antenatal clients in selected Addis Ababa Health Centers.rnMethods: A cross-sectional institution based study was conducted to examine knowledge andrnpractice of birth preparedness and complication readiness among clients at five selectedrnhealth centers by using pretested standard questioner in Addis Ababa. The sampling techniquernwas systematic sampling and the sample size was 290.rnResults: Data were obtained from 290 mothers, yielding a response rate 100%.Taking intornaccount identifying danger sign during pregnancy, labor and during postnatal, and place ofrndelivery identification, means of transportation and saving money. About 42%, 17.2%, 27.7% ofrnthe respondents were knowledgeable about danger sign during pregnancy, delivery, andrnpostpartum period respectively. Regarding to knowledge to birth preparedness 46% of thernrespondents were knowledgeable and 68.0% stated that they were prepared for birth and itsrncomplication. In this study educational status of mothers and their knowledge about danger signrnduring pregnancy was associated. Illiterate mothers were 0.48 times less knowledgeable aboutrndanger sign during pregnancy as compared to those who were secondary and abovern(OR=0.42(95%CI=0.21, 0.82).rnMothers with the income of 500-1000 Birr per month were 2.86 times more likely to havernknowledge about danger sign during pregnancy as compared to those who were with nornincome(COR=2.86 (95% CI=1.41,5.78)) but the significant association between educationalrnstatus, income and danger sign during pregnancy was not retained in the multivariate analysis.rnConclusion and recommendation-The study identified poor comprehensive knowledge andrnpractices on preparation for birth and its complication in the study area. Community educationrnabout preparation for birth and its complication and empowerment of women through expansionrnof educational opportunities are recommended for improving birth preparedness andrnconsequently the effects of pregnancy related complications. The individual woman, her familyrnand the community as a whole should have to be well informed on birth preparedness andrncomplication readiness.