Objective: This study aimed to identify the determinants of early discontinuation of long-acting and reversible contraceptive methods among women within childbearing age in Ethiopia, 2019. Methods: The institutional-based case–control study design was implemented from June to August 2019. Eligible study participants were sampled using systematic random sampling technique. Data were collected using structured and pre-tested questionnaire and entered into Epi Info and exported to SPSS version 20 for further analysis. All variables with a p value of <0.05 at odds ratio of 95% confidence interval in multivariable logistic regression analysis were considered as determinants of early discontinuation of long-acting and reversible contraceptive methods. Results: A total of 825 study participants (206 cases and 619 controls) were included in the study. Decision-making on the use of contraception (adjusted odds ratio: 4.8, 95% confidence interval: 1.4–16.8 and adjusted odds ratio: 5.6, 95% confidence interval: 1.7–18.8), the women who got counseled about side effects of contraceptive methods being 84% less likely to discontinue long-acting and reversible contraceptive methods compared to the women of their counterpart (adjusted odds ratio: 0.16, 95% confidence interval: 0.15–0.4), having two or more children (adjusted odds ratio: 10, 95% confidence interval: 3.7–28), and desire to be pregnant (adjusted odds ratio = 0.15 95% confidence interval: 0.06–0.4) were determinants of early discontinuation of long-acting and reversible contraceptive methods. Conclusion: According to the findings of this study, decision-maker on utilization of contraceptive methods, being counseled on side effects of contraception, number of children, and desire of woman to be pregnant were found to be determinants of discontinuation of long-acting and reversible contraceptive methods. Health care providers should strengthen providing pre-insertion counseling in accordance with the national guideline for family planning services, with an emphasis on potential contraceptive side effects and consideration of counseling on decision-making.