Introduction:Iodine is considered to be one of the most essential micronutrients for the normal physical and mental development of human beings. However, little is known about households' use of iodized salt and associated factors. Objectives:This study was to assess the proper utilization of iodized salt at the household level and associated factors in Hetosa District, Southeast Ethiopia, 2019. Methods:A Community-based cross-sectional study was conducted from August 20 up to September 15/2019 in rural Hetosa District, Arsi Zone, and east-south Ethiopia. A total of 603 households were selected using a systematic random sampling technique. Data were collected employing structured and pre-tested questionnaires by face -to -face interview technique. The use of iodized salt at the household level was tested with the iodine rapid test kit. The data were checked, coded and entered into Epi Info Version 7 and export to SPSS version 21 for analysis.Result: A total of 596 participants were included in this study. The availability of adequately iodized salt was 61.1%. The proportion of proper utilization of iodized salt at the household level was 38.4%.Formal Educational (AOR=1.688, 95%CI (1.002, 2.846)),Practice of iodized salt use (AOR= 3.352, 95%CI (2.160, 5.202)), Knowledge on use of iodized salt (AOR=2.320, 95%CI(1.437, 3.745)) and level of iodine content in salt (AOR= 1.668, 95%CI (1.071, 2.597)) were statistically significant to utilization of iodized salt. Conclusion:Proper utilization of iodized salt remains very low, which was 38.4% in the district and does not meet the national goal. Educational status, level of iodized salt, good knowledge and good practice were significantly associated factors with proper utilization of adequately iodized salt in this study.