A BSTRACT Background: Mothers who attend antenatal care (ANC) late miss the opportunity to receive health information, early interventions, and timely referrals, which leads to problems complicating pregnancy and contributes to maternal mortality. Objective: This study was conducted to assess early initiation of ANC visit and its associated factors in public health facilities at Ambo town administration, Oromiya regional state, Central Ethiopia, 2018. Methods: A total sample of 344 pregnant women who attended their first natal care visit were chosen using a systematic random selection procedure for facility-based cross-sectional research. Data were entered into EpiData Version 3.1. “The EpiData Association” Odense, Denmark (In Danish: EpiData foreningen) and analyzed using IBM SPSS Version 21 - International Business Machines Corporation, (Armonk, New York). Descriptive statistics were applied to describe the magnitude of the variable, and binary and multivariable logistic regression analyses were employed to identify factors associated with the early initiation of ANC visits. Statistically significant association was declared at a 95% confidence interval and P value (<0.05). Results: The study revealed that only 30.5% of the study respondents started their first ANC timely. Initiation of early ANC booking was affected by factors like having good knowledge of ANC follow-up (Adjusted odd ratio (AOR) = 2.25, 95% CI: 1.06, 4.78), primigravida (AOR = 2.52, 95% CI: 1.20,5.32), planned pregnancy (AOR = 2.86, 95% CI: 1.05, 7.81), partners whose occupation were merchant (AOR = 3.47, 95% CI: 1.15, 10.46), know the available service on ANC service (AOR = 3.00, 95% CI: 1.31, 6.88), and having advice from health professionals (AOR = 2.27, 95% CI: 1.05, 4.89); all these factors had shown significant association with timing of first ANC. Conclusion: Early initiation of first ANC was relatively low in the study area. Planned pregnancy, number of pregnancies, knowledge of ANC follow-up, partner’s occupation, knowing the available service on ANC service, and having advice from health professionals were factors associated with it. To improve the situation, it is important to provide continuous public health education on the importance of early initiation of ANC at public health facilities.