Abstract:Introduction: Institutional delivery service utilization is essential to improve maternal and child health. However, little is known about institutional delivery service utilization in Woldia, Ethiopia. This study was aimed at assessing institutional delivery service utilization. Methods: Community based cross sectional study was done on 478. Census was carried out in two urban and one rural kebeles (the smallest administrative unit) to identify mothers who gave birth in the past five year. Mothers were selected by systematic random sampling technique. Quantitative data and qualitative data were collected by means of a pretested questionnaire and in-depth interview guide, respectively. Bivariate and multiple logistic regression analysis were done by using SPSS version 20; P-values ≤ 0.05 were considered as statically significant. Results: The study showed that 48.3% of institutional delivery service utilization. Mothers' residences, educational status, being informed about place of delivery at their last pregnancy were main factors associated to institutional delivery service utilization. Conclusions: Institutional delivery service in Woldia was low. It is recommended that motivating mothers through formal education and awareness creation about the benefit of institutional delivery service utilization and the risk of home delivery should be given due attention by the local health workers.