Introduction: globally maternal and neonatal tetanus persist as publicrnhealth problems in 46 countries, mainly in Africa and Asia. Neonatal tetanusrnis responsible for 14% of neonatal death and maternal tetanus is responsiblernat least for 5% of maternal Deaths. TT2+ coverage among pregnant mothersrnhad stand still at between 30-40% in most African countries. In Ethiopiarnonly 32% of the pregnant mothers have received TT2+ in 2006. West ShoarnZone is one of the nine high risk zones of the country with low TT coverage.rnObjective: To assess factors influence the utilization of Tetanus toxoidrnimmunization and Protection at birth in study area.rnMethods: A community based cross-sectional study was conducted fromrnDec. to May 2011 on mothers aged 15-49 years who have at least one Underrnfive years old Child. A multi stage sampling technique was used to select thernsample of 680 women. Data was collected through structured pre tested andrnsemi structured questionnaire and check lists. Data were entered andrnanalyzed in SPSS version 15 soft ware. A univiriate, biviriate andrnmultivariate analysis were done using frequency, percentages, and binaryrnlogistic regressions respectively.rnResults- A study showed that from a total of child breang age women in thernstudy area only 32% of mother immunized for valid Tetanus toxoid dose andrnonly 28 % of children were protected at birth against neonatal tetanus asrnevidenced by card alone.rnBivariant and multivariate analysis showed significant association betweenrnValid TT dose immunization and maternal education, income, marital status,rnplanned pregnancies, husband literacy status.rnConclusion, there is low Tetanus toxoid immunization and protected atrnbirth in the area. Demographic and socio cultural factors were found to bernbarriers to utilization of tetanus toxoid immunization services.rnIntegrating maternal health services and promotion of information, educationrnand communication in the community are recommended.