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BACKGROUND: Giving birth in a medical institution, under thecare and supervision of trained health-care providers, reduces therisk of maternal mortality and promotes child survival. Despite this,most mothers in Ethiopia are giving birth at home. Thus, this studywas conducted to assess the level of skilled delivery service use andassociated factors among mothers in Enarje Enawga District,Northwest Ethiopia.MATERIALS AND METHODS: A community-based cross-sectional study design was employed to recruit a total of 777mothers who gave birth in the last two years. Data were collectedusing structured questionnaire. Bi-variable and multivariablelogistic regression analyses were employed to assess factorsassociated with skilled delivery service use. Odds ratios with 95%confidence intervals were computed.RESULTS: Only 156 (20.1%) of the mothers had utilized skilleddelivery service in the last two years. Mothers aged 15-24 years(AOR = 5.57), residing in urban areas (AOR = 1.80), and residingwithin a walking time of 16-30 minutes from health facility (AOR =3.52) were more likely to use skilled delivery practice. Additionaly,mothers who had four and more antenatal care (ANC) visits (AOR= 4.94) and mothers who received health education (AOR = 5.04)were more likely to use skilled delivery service.CONCLUSION: The level of skilled delivery service use amongmothers was low. Age, residence, distance from health facility,number of ANC visits and health education were found to beassociated with skilled delivery service use. Community-basedhealth education programs regarding the risks of home delivery isnecessary with a special focus on younger mothers residing inrural area.