Background: According to World Health Organization (WHO) adolescents are defined asrnpersons between 10 and 19 years of age; nearly 20% constitute Ethiopian population and fourfifthrnlive in rural areas. Studying their reproductive health knowledge, services utilization andrnassociated factors is highly relevant to design age-appropriate program interventions andrnstrategies in the local context.rnObjective: To assess the reproductive health knowledge and services utilization among ruralrnadolescents in Machakel woreda, East Gojam Zone, Amhara National Regional State, NorthwestrnEthiopia.rnMethods: A community-based cross-sectional study was conducted to assess the reproductivernhealth knowledge and services utilization of rural adolescents in Machakel woreda. The studyrnemployed both quantitative and qualitative methods. A systematic random sampling techniquernwas used to select 415 adolescents from eligible households. Data were collected throughrnstructured pre-tested questionnaire and using in-depth interview guides. The data were enteredrninto Epi Info and analyzed by using SPSS software for windows. Univariate, bivariate andrnmultivariate analyses were done.rnResult: More than two-third (67%) of the adolescents were knowledgeable about reproductivernhealth issues. Late adolescence (AOR=3.77, 95%CI (3.1, 8.98)), residing with grandparentsrnand/or other relatives (AOR=2.21, 95%CI (1.81, 6.04)) and being from rich families (AOR=3.37,rn95%CI (1.65, 6.87)) were associated with reproductive health knowledge. However, only a fifthrn(21.5%) of the adolescents have ever utilized reproductive health services. Parent (s)rndisapproval, lack of basic information and pressure from partners were found to deterrnadolescents from accessing reproductive health services. Late adolescents had more tendenciesrnto use reproductive health services (AOR=2.18, 95%CI (1.13, 8.03)). The likelihood of utilizingrnreproductive health services was significantly associated with knowledge for reproductive healthrn(AOR=1.23, 95%CI (1.23-4.21)).rnConclusion: It was found that reproductive health knowledge and services utilization amongstrnrural adolescents remained insufficient. Community-conversation in line with adolescent-toadolescent-rncounseling, peer education and parent-adolescent communication should addressrnsensitive topics such as sex education and other reproductive health issues