BackgroundPersonal protective equipment is designed to protect workers from serious workplace injuries or illnesses resulting from contact with chemical, radiological, physical, electrical, mechanical, or other workplace hazards. ObjectiveTo determine Personal Protective Equipment utilization and its associated factor based on health belief model among large scale factory workers in Debre-Birhan, Ethiopia. MethodsAn institution-based cross-sectional study was employed in Debre Berhan Town, North Shoa Ethiopia from April 1 st to May 1 st , 2021 using an interviewer administered structured questionnaires. A total of 412 samples were selected by systematic random sampling method. The data was entered by Epi-data version 3.1 and analyzed by SPSS. variables with a p-value of 0.2 was fitted for multiple logistic regressions and a p-value of <0.05 was statistically significant. ResultA total of 412 workers were participated in the study with a 100% response rate. The mean age was 29 (±7.3) years. Most workers 367 (89 %) knew that PPE can prevent work related injury and illness. Over all 172 (41.7 %) of the workers were considered to have good PPE utilization. Perceived susceptibility [AOR=1.2, 95 %, CI (1.076-1.38)], perceived severity, [AOR=1.1, 95 %, CI (1.088-1.163)], perceived self-efficacy, [AOR=1.2, 95 %, CI (1.082-1.349)], and Perceived barrier [AOR=0.87, 95 %, CI (0.800 -0.956)] were found to be significant predictors of good PPE utilization. ConclusionThe study revealed that good Personal protective equipment utilization in large scale factory workers. Perceived susceptibility perceived severity, perceived barrier and perceived self-efficacy were found to be predictors of PPE utilization.