Background: East Shoa Zone is one of the 14 Zones in Oromia Regional States accountingrnmore than half of malaria burden annually. Among 12 Woreda in the Zone Adama Woreda isrnhighly malarious, almost 95% of the land malarious and 91% of population at risk. Overrn20,000 bed ITNs were distributed in the area. Additionally, the role of Social marketing is notrnnegligible. Despite the efforts to achieve the goal, locally there is critical lack of informationrnabout ITNs ownership by households, utilization among under 5 children and pregnantrnwomen and factors affecting utilization.rnObjective: The study is aimed to assess the proportion of Insecticide Treated Nets ownershiprnby households, utilization among under 5 children and pregnant women and factors affectingrnownership and utilization of Adama Woreda.rnMethod: Community based cross- sectional survey was conducted during September 2006.rnPrimarily, the malarious villages were stratified as rural, suburban kebeles and factory camps.rnThe existing households were identified using registration list available at Woreda healthrnoffice. Study units were identified by multistage random sampling technique. A total samplernof 845 households was proportionally selected. Both self-reported information and directrnobservations were used to collect data. Data was entered to the computer usingrnEpiinfoVersion6 and analyzed in SPSS 11.0 version statistical software. Tables and figuresrnwere used to present the data. Frequency distribution, percentages and Odds Ratio with 95%rnlevel of confidence were calculated and interpreted accordingly.rnResult: A total of 826 households were assessed, among which 494 and 116 households werernassessed with children under 5 years of age and pregnant women, respectively. Four hundredrnand ninety seven (59.7%) households were observed owning at least one ITN. Three hundredrnand four (61.5%) children and 73 (62.9%) pregnant women were living in the householdrnowning at least one mosquito net. Direct observation of household has confirmed that onlyrn20.2% and 14.7% of children and pregnant women respectively, were utilizing properlyrnmounted ITNs. Self-reported utilization was over reported compared to direct observation.rnRegarding a factor for non-owning of ITNs, high price and Locating for free distribution werernamong the major once. Among major factors for none utilizing, absence of mosquito in thernhouse (53.8%), and forget to mount net (34.6%). In general, knowledge and practice of ITNsrnwere significantly associated with place of residences, educational status and healthrninformation of the respondents.rnConclusion and RecommendationrnThe coverage of ITNs in the area is highly encouraging, although the significant proportion ofrnhouseholds was not covered. Not all mosquito nets owned by households were being properlyrnutilized used by young children and pregnant women. Significant proportions of vulnerablerngroups were not covered. Hence, prioritizing vulnerable groups during distribution, householdrneducation on careful and consistent utilization of bed net with great emphasis to high risk andrnpriority groups and district level educational monitoring and regularly ongoing survey werernrecommended.