Background HIV/AIDS is the greatest and most urgent public health problem that the world is facing today. Antiretroviral therapy (ART) is the treatment option for people infected by the HIV virus and helps them to lead longer and healthier lives and improve their quality of life. This study aimed to measure level of satisfaction and associated factors among patients receiving ART services in ART Clinics at Jimma Town Public Health Facilities, Southwest, Ethiopia. Methods Facility-based, cross-sectional study was employed from March to April, 2018 among 383 clients attending ART in three public health facilities of Jimma town. Data was collected using exit interviewer administrated pre-test structured, coded and entered using Epi-data version 3.5.1 and then exported and analyzed using SPSS version 20 software. Variables having p < 0.25 at bivariate analysis were fitted to multivariate analysis. OR, P-value and 95% CI were computed to show the association of variables (p < 0.05). Results A total of 383 clients involved in the study. The majority of the study participants, 253 (66.1%), were females and 163 (42.6%) were in 28–37 age category. The overall satisfaction rate for ART service provision was 89.6%. Patients were satisfied with the availability of ARV drugs, measures taken by health care providers to keep confidentiality and location of the clinic in the facility, 97.9%, 93.2% and 96.3%, respectively. The findings of this study revealed statistically significant associations between the patients’ satisfaction and duration of stay on ART and waiting time to get service (p<0.05). Those patients who stayed 36–60 months on ART treatment were 82.5% less likely to be satisfied than those who stayed less than 12 months on ART treatment (AOR=0.175, 95% CI: 0.04–0.771). Conclusion Overall, most respondents were satisfied with ART services provision. Factors like duration of stay on ART and waiting time to get service should be taken into consideration to improve the patient’s satisfaction.