Background: Scabies is neglected parasitic disease and major public health problem worldwide, particularly in resource-poor regions including Ethiopia. It has been estimated about 300 million cases reported yearly and causes more than 1.5 million Disability Adjusted Life Years for all age. The study conducted in Ethiopia, among ‘Yekolo-Temari’ revealed 22.5% scabies prevalence. On March 9, 2019, the Sinana district surveillance office reported a scabies outbreak in five madrasahs. We investigate to determine its magnitude, identify risk factors and provide intervention and recommendation.Methods: We conducted a (1:2) unmatched case-control study. The scabies case-patient was any student of madrasahs in Sinana district with signs and symptoms consistent with scabies (superficial burrows, intense itching especially at night, generalized rash and secondary infection) from March 11 to April 30, 2019. We reviewed the line list and conducted active case finding. Participants were recruited from all madrasahs (five) proportional to the number of students in each madrasah (56 cases-patients and 111 controls) and interviewed with structured questionnaires. We use OR, P-value and 95% CI to measure the strength of association in multivariable logistic regression. Result: We identified 815 (6 crusted) scabies cases-patients (100% male) with the attack rate 143 per 1000 population (815/5,689) and no death and the mean age was 14 years (range 8-28 years). Sharing bed with scabies case (AOR=3.9, [95% CI=1.5-10.3], travel history to scabies area (AOR=3.87, [95% CI=1.19-12.56], showering more than a week interval (AOR= 2.74, [95% CI=1.04-7.21] were statistically associated with illness.Conclusion: Sharing bed with scabies case, travel history to scabies area and showering more than a week interval was associated with a high frequency of scabies infestation. All patients and contacts treated, additionally, at two madrasahs mass drug administration conducted with permethrin, and cloxacillin for secondary infection. We recommend health education about the transmission, prevention and control of scabies disease to the students.