Background: Asthma attacks are life-threatening episodes that place a costly burden on the individual and the community in both high-and low-income countries including Ethiopia. There is scant information on the determinant of it in the study area. Objective: To identify determinants of asthma attack among adult asthmatic patients attending at public hospitals of West Shoa Zone, Oromia Regional State, Ethiopia. Methods: An institutional-based unmatched case-control study design was conducted. In this study, 300 participants (100 cases and 200 controls) were included. A pre-tested structured questionnaire was used to collect data. After the data were entered into Epidata version 3.1, it was exported to SPSS version 25 for analysis. First, bivariable logistic regression was performed. Independent variables with a p-value < 0.25 in binary logistic regression were entered into a multivariable logistic regression model. In the multivariable logistic regression model, independent variables with a p-value < 0.05 were considered to be significant determinants of the outcome variable of the study. Results: This finding identified that upper respiratory tract infection (