Background: Sexual violence is a common and serious public health problem. The mostrncommon place where sexual violence is experienced is school. Sexual violence usually occursrnwhen she is unable to understand the situation. The most important cause for this is substancernuse.rnObjective: The objective of the study was to assess the prevalence of sexual violence and itsrnassociation with substance use among female students in Mizan-Tepi University.rnMethods: Cross sectional institution based survey, using self-administered, anonymousrnquestionnaire and focus group discussions were done among female students of Mizan-TepirnUniversity from January to February 2012 to assess prevalence of sexual violence and itsrnassociation with substance use. A total of 604 female students were involved in the study.rnPrevalence was determined using frequencies and logistic regression was used to estimate oddsrnratios and 95% confidence interval using SPSS statistical package.rnResult: Among respondents 66.3% and 63% were sexually harassed since joining the universityrnand in the current academic year respectively. The prevalence of attempted rape was 19.6% andrn13.7% since joining the university and in current academic year respectively. The magnitude ofrnrape was 13.5% and 8.9% since joining the university and in current academic year respectively.rnThe life time prevalence of sexual harassment, attempted rape and completed rape was 75.4%,rn33.5% and 20.7% respectively. Experiencing of rape in current year was significantly associatedrnwith khat chewing (AOR= 4.24: 95% CI 1.92, 9.37), smoking cigarettes (AOR= 6.76: 95% CIrn2.99, 15.28), drinking alcohol (AOR= 3.27: 95% CI 1.51, 7.11), having drinking friend (AOR=rn5.60: 95% CI 2.46, 12.74) and using other substances like cocaine (AOR= 6.43: 95% CI 1.91,rn21.64). FGD discussants explained that sexual violence is prevalent due to lack of facilities andrnavailability of substances around the campus.rnConclusion: The magnitude of sexual violence among female students of Mizan-Tepi Universityrnwas very high. There was significant association between rape and substance use by femalernstudents. Therefore it needs urgent attention from concerned bodies to alleviate the problem.