ObjectiveThis study aimed to assess the knowledge, attitude and the associated factors regarding spectacle use among adults living in Debre Birhan Town, North Shewa, Ethiopia.DesignA community-based, cross-sectional study was conducted using a multistage sampling method.SettingThe study was conducted in Debre Birhan Town, North Shewa, Ethiopia.ParticipantsThe study included 1022 adults aged ≥18 years living in Debre Birhan Town for more than 6 months.Main outcome measuresData were collected using face-to-face interviews completed by an interviewer.ResultsThe study included 1022 adults with a median age of 45 years. Of the participants, 86.01% (95% CI 83.88, 88.14) had adequate knowledge and 85.32% (95% CI 83.15, 87.50) had favourable attitude towards spectacle use. Older age (adjusted OR (AOR)=1.21, 95% CI 1.17, 1.26), higher educational status (AOR=2.65, 95% CI 1.06, 6.60), history of spectacle use (AOR=3.20, 95% CI 1.31, 7.83) and family history of spectacle use (AOR=4.75, 95% CI 2.31, 9.75) were positively associated with having adequate knowledge of spectacle use. Higher educational status (AOR=2.56, 95% CI 1.26, 5.21), history of spectacle use (AOR=3.22, 95% CI 1.58, 6.55), family history of spectacle use (AOR=1.89, 95% CI 1.13, 3.16) and adequate knowledge about spectacle use (AOR=4.63, 95% CI 2.69, 7.98) were positively associated with having favourable attitude towards spectacle use.ConclusionThis study revealed a good proportion of adults with adequate knowledge and favourable attitude towards spectacle use. Higher educational status, history of spectacle use and family history of spectacle use were significantly associated with having adequate knowledge and favourable attitude towards spectacle use.