ObjectiveThe availability of iodine concentration in iodised salt at the household level does not guarantee the prevention of iodine deficiency disorders, but it can be significantly assured through proper utilisation. In eastern Ethiopia, there are no data on the use of iodised salt at the household level. The purpose of this study was to determine the iodine concentration, the coverage of adequately iodised salt and the factors that influencing the proper iodised salt utilisation in households.DesignA community-based cross-sectional study was conducted. Data were collected through face-to-face interviews and iodine concentration was determined using the WYD Checker iodine test. We used the logistic generalised estimating equation statistical analysis method to assess the factors that affect proper iodised salt utilisation at a household level.SettingThe study was conducted in Dire Dawa City Administration, Eastern Ethiopia.ParticipantsA total of 473 households were selected using one-stage sampling technique.Primary measuresIodine concentration, availability of adequately iodised salt and proper utilisation were primary outcomes of this study.ResultsOnly 37% of households found sufficient iodine concentration in iodised salt, while only 25.2% of households used iodised salt properly. College or above education (adjusted OR=5.1, 95% CI: 1.2 to 21.6, p=0.024), good knowledge (adjusted OR=5.3, 95% CI: 4.3 to 13.4, p<0.0001), good attitude (adjusted OR=4.2, 95% CI: 2.5 to 7.0, p<0.0001) and household with family size >5 (adjusted OR=0.39, 95% CI: 0.23 to 0.7) were significantly associated with proper utilisation of iodised salt.ConclusionsAdequate coverage and iodised salt utilisation were low. The proper use of iodised salt is associated with educational status, family size, knowledge and attitudes. Raising public awareness, health promotion and continuous regulation of iodine concentration at all levels by regulatory bodies are important strategies for addressing the public health problems of iodine deficiency and related diseases.