Background: Utilization of modern contraceptive methods is related to sociodemographic,rnreproductive and fertility factors. Previous studies concentrated onrnidentifying these and other determinant factors in rural or urban but it is unclear whetherrnthe magnitude of these factors in rural and big urban population similar or not.rnObjective: The objective of this study is to assess and compare factors influencingrnutilization of modern contraceptive methods among rural and urban women currently usingrnfamily planning service in South Wollo Zone, Amhara Region.rnMethods and materials: Health facility based comparative cross-sectional study wasrnconducted in Dessie town, Jamma and Wereilu Weredas of South Wollo Zone fromrnFebruary to March-2010.The Two rural Weredas were selected from the ten remoternweredas located in the western part of the Zone by using simple random sampling methods.rnAll health centres and one potential health post per weredas were the study unit. Afterrnobtaining permission to proceed from all level of relevant bodies, data were collected byrntrained health workers using pre-tested interviewer administered close ended questionnairesrnfrom 534 women who visit 12 health facilities as current MCM users. Data were enteredrnand analysed using SPSS Soft Ware.rnResult. Rural women use modern contraceptive methods for the first time on average afterrnthey had 3 children and only (4.5%) of users before the first child as compared to urbanrnusers after they had 1.4 children and (24.3%) before the first child. Desire to limit familyrnsize by rural users less (25.8%) than (31.5%) urban users. Decision making to use modernrncontraceptive by rural users less (21.7%) than urban users (25.5%).(90.3%) of rural andrn(86%) of urban users had past history of pregnancy. Rural women whose perceivedrneconomic status as average were three times more likely to practice modern contraceptivernas compared to urban women.rnConclusion: This study has clearly described that rural women use modern contraceptivernmethods after they had higher number of children and less desire to limit family size asrncompared to urban women. It is recommended that strong behavioural change interventionrntargeting the high fertility desire of rural women and modern contraceptive methodsrnutilization is needed.