World wide, young women and men suffer a disproportionate share of unplannedrnpregnancies, sexually transmitted diseases, including HIV/AIDS, and other seriousrnreproductive health problems. This cross-sectional community based descriptivernstudy was conducted in West Harargie, Assebe Teferi, with the main objectives ofrnassessing magnitude of risky reproductive health behaviors of youth, level ofrnsubstance use, magnitude of factors that influence the preference and utilization ofrnhealth services and examining youth attitude and willingness to VCT. Based onrnprobability proportionate to the population size of each kebele and sub zones, lotteryrnmethod was used to identify the study population.rnOut of targeted 844 youth aged 15-24, 774 responded to the structured questionnaire,rnout of which 375 (48.4%) were male, with male to female ratio of 1:1.06. Among thernstudy participants, 490 (63.3%) belong to age 15-19, and 106 (13.7%) were married.rnSixty seven percent of them married before reaching to age 18, with mean age 17.2 +rn2.4 years. It was also identified that 9% of the marital lock were by abduction.rnOut of the total respondents, 35.6% were sexually active, comprising 34.53%rnmarried and 65.47% unmarried. Eight point one percent of the sexually active grouprnhad reported that during their first sexual intercourse they were being victims of rape.rnIn addition to this, hundred forty two (70.65%) of unmarried sexually active grouprnhad unsafe sex at their first intercourse, (not used condom). Consequently, 13 (4.2%)rnand 32 (10.4%) of them encountered STDS and Unwanted Pregnancy at their firstrnsexual exposure, respectively. Ever use of Modern Contraceptive was found to bern25.7% among the sexually active group, while condom utilization at the lastrnintercourse was 63.2% among unmarried. Because of unsafe sexual practice, 29rn(9.41%) of the sexually active had history of STDs in the last one year prior to thisrnstudy, out of which 2.3% of the cases were among married. It was also reported thatrn102 (33.2%) of the sexually active youths encountered unwanted pregnancy inrnviirntheir life time sexual relations with partners, out of which 30.4% of the cases werernended with abortion.rnThe magnitude of substance use among the youth was assessed and it revealed thatrn420 (54.3%) of the respondents had exposure to the substance use and thirty eightrnpercent of them reported that their sexual desire rises following substance use. In thernassessment of utilization and preference of the health institution, thirty six pointrnseven percent of the respondents preferred to be served in FGAE clinic. On the otherrnhand, 18.7% of the study group claimed that the existing HI was not welcomingrnwhen needing a service, the reasons were, 73.4% and 58.3% of them complainedrnprolonged waiting for the service and service inconsistency, respectively. Because ofrnthese, youth friendly health service was suggested to be available and 316 (41%) ofrnthe youth indicated the need to rearrange in the existing health institution having itsrnown unit, and thirty six point seven percent of the them preferred to be served byrnyoung and of the same sex. This study also revealed that 88.5% of the respondentsrnhave VCT information and 92.2% of them reported that they need to have VCT.rnLogistic regression analysis indicated that, female were more vulnerable to riskrnreproductive behaviors as compared to their male counterpart. On the other hand, thernolder group was found to have more risky reproductive behavior as compared to thernyounger one. It was also observed that married group had risky reproductivernbehaviors as compared to non married. Similarly, those who used the substance andrnthose who had pocket money were also indicated to have an association with riskyrnreproductive behaviors. From this study it was concluded that youth in the study arearnwere exercising high risky reproductive behaviors that exposed them to various RHrnproblems, and Youth focused health services were not well organized thus needs therncollaboration among different sectors and the community to facilitate youth friendlyrnhealth services to promote youth health.