Backgroundá¡ About 29% of couples in Ethiopia are not using any contraceptive methods to rneither space or limit childbirth. In addition long acting and permanent contraceptive methodrnutilization is less than five percent. rnObjective: Is to assess level of utilization of long acting and permanent contraceptive methodsrnand associated factors among married women in Adama town. rnMethodology: Community Based Cross Sectional Study complemented with Qualitative methodrnwas conducted in four kebeles of Adama town from April15-30, 2014. Multistage samplingrntechnique was used to select participant for quantitative part where as purposive sampling wasrnused for qualitative part of the study. Quantitative data was cleaned and entered using Epi inforn3.5.3 and analyzed using statistical package for social science version 20.0. Open code versionrn3.6.2.0 was used to code qualitative data. Factors associated with utilization of long acting andrnpermanent contraceptive method were identified using logistic regression model and contentrnanalysis was done for qualitative data. rnResult: Eighty seven percent of the respondents knew long acting and permanent contraceptivernand 55% had positive attitude about it. Magnitude of long acting and permanent contraceptivernmethod was 20.9% and the main reason for not using was fear of side effect (63.5%). Current usernlong acting and permanent contraceptive method was higher among women who have highrnknowledge (AOR=5.26, 95% CI=1.90-14.69) and positive attitude about the method (AOR=3.25,rn95% CI=1.60-6.58). Participants need to have more children use this method less likely comparedrnto those did not want to have more children. Those who gave birth to 3-4 used long acting andrnpermanent contraceptive methods more likely than those who did not give birth. In qualitativernpart, discussants have expressed their concern of side effect though they had knowledge aboutrnthis method. rnConclusion and recommendation: Current use of long acting and permanent contraceptivernmethod in Adama town was low. The main reason for not using was fear of side effect. Mainrnfactors identified to affect use of this method were level of knowledge and attitude about longrnacting and permanent contraceptive methods. Targeted Information Education CommunicationrnIntervention should be intensified to improve utilization of this method.