Background: Health workers adherence to health care facility standards is a complicated process. So, when health professionals comply with standards, they must first become aware of the standards, then intellectually agree with them, then decide to adopt them in the care they provide, and then regularly adhere to them at appropriate times. Health workers simply cannot be familiar with standards because they have not been communicated clearly. Commonly, providers are aware of standards but may hold beliefs or attitudes that inhibit them from adhering to them. Evidence on awareness and adherence to healthcare facility standards among health workers working in Private health facilities in low-income countries are poor. Objectives: The aim of this study was to assess the level of awareness and adherence to healthcare facility standards among health workers in selected private medium clinics in Addis Ababa. Methods: A facility-based cross-sectional descriptive study design was used to conduct the study, and the study units were selected using a simple random sampling technique. Descriptive statistics, including frequencies and percent, were used in order to summaries variables. To determine the association between each variable, a binary logistic regression model was used, and variables with a p-value less than 0.05 were considered statistically significant. OR and CI were used to see the strength of the association between the independent variables, awareness, and adherence. Result: A total of 372 participants were included in the study, which makes the response rate 100% with a mean age of 35.98 years. The majority, 56% of whom were male, and 72% were not heard about Ethiopian medium clinic standards, even though 95.8% of them had no on-the-job training on them. Further, 22.4% and 44.8% of the study participants had good levels of awareness and adherence, respectively. Factors such as the age interval of 21–25 years (AOR 0.19, 95% CI 0.06–0.60) and 26–30 years old (AOR 0.06, 95% CI (0.01, 0.32)) had a statistically significant association with a level of adherence as compared to the 20- and below-age groups. But not participating in informing about the Ethiopian medium clinic standard (AOR 1017.49, 95% CI (35.99, 28768.10) was the only variable that had a statistically significant association with level of awareness. Conclusion and recommendation: study result indicated that almost more than half of participants had poor levels of awareness and adherence towards the Ethiopian-medium clinics standards. Therefore, providing continuous per-recruitment and on-the-job educational training on Ethiopian-medium clinics supported by health institutions are essential.