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Background: Cesarean section is an effective technique for preventing maternal and perinatal mortality when performed properly. Evidence suggested that pregnant women who have had good knowledge about their condition are able to participate in shared decision-making and can alleviate fears related to anesthesia. However, only a few studies conducted in Ethiopia assess the level of knowledge and attitude of pregnant women towards anesthesia for cesarean section.Methods: Hospital based cross-sectional study was conducted from April 18 to June 25, 2021. A systematic random sampling technique was used to select a total of 362 pregnant women attending antenatal care. Pretested and structured questionnaires were used to collect the data using a face-to-face interview. Both bivariate and multivariable binary logistic regression models were used for statistical analysis. The adjusted odds ratio was used as the measure of association. P-value less than 0.05 at 95% CI was considered as statistically significant.Results: A total of 354 pregnant women attending at ANC clinic participated with a response rate of 97.8%. The overall proportion of good knowledge and positive attitude towards anesthesia for cesarean section were 56.5% (95% CI: 51.4%, 61.9%) and 50.8% (95% CI: 45.8%, 56.2%), respectively. Pregnant women who had previous operations (AOR=4.47, 95% CI: 1.77, 11.32) and had any health information about anesthesia (AOR=10.06, 95% CI: 5.41, 18.69) were significantly associated with good knowledge towards anesthesia for cesarean section. While, pregnant women who have had secondary education (AOR=6.71, 95% CI: 1.19, 37.99), college and above education (AOR=13.63, 95% CI: 2.26, 82.21), and had health information about anesthesia (AOR=2.02, 95% CI: 1.09, 3.77) significantly associated with a positive attitude towards anesthesia for CS.Conclusion: This finding means that a significant number of pregnant women still have poor knowledge and attitude towards anesthesia for CS. Previous operation and health information about anesthesia were significantly associated with knowledge while higher education and health information about anesthesia were significantly associated with a positive attitude towards anesthesia for cesarean section. Health professionals need to provide health information during ANC visits and in the operating theater areas for mothers who have indications for CS.