Back ground: Studies in a number of countries have shown that wherever indiscriminate waste disposal is high, infant and child mortality rates are high. Although utilization of environmental health services is an important indicator for measuring success of the health extension program; data on environmental health services of urban health extension program are scarce in the study area and elsewhere in Ethiopia. Objective: To assess utilization of environmental health services of urban health extension program and associated factors in Debretabor town, Amhara region, Ethiopia. Methods: A community based cross sectional study was conducted in Debretabor town from September 1-30, 2013. A total of 422 households were included in the study using systematic sampling technique. Data were collected using structured questionnaire and analyzed using SPSS version 16.0. Degree of association between independent and dependent variables was assessed with a 95% confidence level and p-value less than 0.05 was used to detect statistical significance. The findings of quantitative data were triangulated with the qualitative one. Result: In this study 69.8% and 65.5% of households practiced proper solid and liquid waste management mechanisms respectively. Income was found to be predictors for liquid waste management (AOR=1.82) Educational status of respondents was found to be predictors for liquid waste management (AOR=1.83). Conclusion: Solid and liquid waste management practices were lower than the minimum 75% expectation of the national health extension program package and, Educational status, house ownership, income and graduated as model family were main factors affecting environmental health services. Improving socio economic status of households, provision of continuous advice and technical support at household level on the utilization of environmental health service are recommended.