Patients have explicit needs for health care when they visit health facilities and their satisfaction embodies the patients' perceived needs and expectations and they use waiting time as a decisive factor in choosing a health service provider. Hence, the aim of this study was to assess patient satisfaction with waiting time among outpatients and associated factors at Nekemte referral hospital. The study was conducted at Nekemte Referral hospital in Ethiopia. A cross-sectional study design was used to collect data between May 01 and 30, 2016. A 420 samples size was determined using a single population proportion formula. Data entry and analysis were done using SPSS version 20. Descriptive statistics, univariate and multivariable logistic regression were performed. From a total of 420 interviewed participants, 387 of them responded to the interview making 92.2% response rates. The majority of the participants were male 248 (64.1%) and from urban area 270 (69.8%). The overall satisfaction of outpatients with waiting time was 57.1% and the factors significantly associted with satisfaction toward waiting time to receive health care at outpatient departments of the hospital were waiting time to get registration, waits for visiting physician, waits for laboratory services, waits for drugs, and waits for payment. The overall outpatient satisfaction with waiting time to receive health services at outpatient departments of Nekemte referral hospital was relatively low compared to other many study findings and we recommend the hospital to reduce the waiting time to ≤30 minutes for health services at each outpatient department to increases outpatient satisfaction with waiting time.