Background፡Trachoma is the neglected eye problem and the primary cause of preventable corneal blindness. In endemic areas, an initial infection can occur in early childhood, and when there is recurrence, it progresses to scarring and blindness. In the past certain decades, trachoma eliminated from developed countries through enhancements of hygiene and sanitation under immense commitments of the governments but still a problem of developing countries. Studies and reports also indicated that the Amhara region had the highest prevalence of trachoma of the other regions in Ethiopia. Thus, the aim of this study was to asse{Birlie, 2016 #48}ss prevalence and risk factors of active trachoma among rural preschool children in Wadla district, Amhara region, north Wollo zone, northern Ethiopia. Methods: Although the sample size was 583, a total of 596 children were screened for signs of active trachoma because of the sampling procedure nature, cluster sampling technique. Wadla district was had 150 rural villages, which were similar in topography and socio-demographic status. Of these villages, 30 were selected randomly as sites of data collection. An interview on the socio-demographic status with heads of households was held by health informatics professionals. The interview questioners were prepared through reviewing the literature and pretested in Meket Woreda. Eye examination was performed by integrated Eye care workers who were trained for one month for the purpose of trachoma screening. They were also involved in two national trachoma surveys as trachoma sign graders for Carter center-Ethiopia. Results - The prevalence of active trachoma among rural pre-school children in Wadla district was 130 (21.8%). On logistic regression, poor economic status (AOR (95% CI), (3.8 (1.3-11.4), being in 37- 48 months old (AOR (95% CI), (4.2 (1.5-12.0), lived in thatched house roof (AOR (95%CI), (4.4 (1.4-13.6), presence of fly in nearby home (AOR (95% CI), 4.6 (2.1-9.9), once weekly face washing frequency (AOR (95% CI), 8.6 (2.5-29.3), unwashed child’s face for longer than a week (AOR (95% CI), 10.6 (2.9-37.7), not using soap while washing children’s hand (AOR (95% CI), 4.5 (1.8-11.3), and absence of latrine (AOR (95% CI), 5.1 (2.0-12.9) were had association with active trachoma