Background Bilateral tubal ligation is a highly safe and effective form of permanent contraception for couples who want no more children. However, it is the least known and used form of contraception in Ethiopia. Objective To explore the lived experience and perception of women using the bilateral tubal ligation method in Southern Ethiopia. Methods Qualitative phenomenological study design was employed. The study participants were recruited by purposive sampling. The data were collected through in-depth interviews and supportive field notes from March 25 to April 24, 2021. All Interviews with the participants were recorded using a digital audio recorder. Inductive thematic analysis was done using Colaizzi’s (1978) seven-step phenomenological analysis framework. Data coding was done using Open code software version 4.03. Results A total of fifteen participants were included in the study. Women’s satisfaction, male partner involvement, perception of women using bilateral tubal ligation, socio-cultural influences, client follow-up, and socio-economic impact of bilateral tubal ligation use are the major themes identified in the study. Findings revealed that most of the participants are satisfied with the method and became more productive and got the freedom to participate income-generating activities. The dominance of socio-cultural influences, male partner’s involvement, and client follow-up after the procedure are the common themes that emerged which determine the user’s experience. Conclusion Lack of supportive involvement of partners, community pressure, lack of women’s decision-making capacity and inadequate follow-up of women in the post bilateral tubal ligation use by healthcare workers are emergent experiences in the current study. Hence, promoting behavioral change communication for community members regarding bilateral tubal ligation use, empowerment of women’s economic, educational, and decision-making capability and healthcare workers’ follow-up of women in the post bilateral tubal ligation period are recommended.