Background: Community-based health insurance is recognized as a promising tool for health system improvement and financial protection for low-income individuals that improves the health status of enrollees and enhances productivity and labor supply. The program is implemented in several districts, however, studies focusing on clients’ satisfaction provided by the health insurance scheme are still limited. The aim of this study was, therefore, to assess individuals’ satisfaction of utilizing health care service with insured and non-insured under community-based health insurance in Mahal Sayent district, South Wollo.rnMethods: Community-based comparative cross-sectional study was conducted among 346 households who are both enrolled and non-insured to the community-based health insurance in south Wollo, Mahal Sayent district from December 1 to April 20, 2021. The data was collected using a structured questionnaire and checked for completeness, entered, edited, cleaned by Epi-data version 3.1 and analyzed by SPSS version 20. Descriptive statistics were used to present the variables. Multivariable logistic regression was fitted to examine the relationship between outcome variable and independent variables. Finding was reported using adjusted odds ratios with 95% confidence interval and statistical difference was declared at P-value