Background. Personal protective equipment was designed to protect workers from serious workplace injuries or illnesses resulting from contact with chemical, radiological, physical, electrical, mechanical, or other workplace hazards. Use of personal protective equipment has been identified as an important hazard control strategy in work environments where it may not be practical to adopt other strategies. Objective. To determine personal protective equipment utilization and its associated factors based on health belief model among large scale factory workers in Debre-Birhan, Ethiopia. Methods. An institution-based cross-sectional study was employed in Debre-Birhan Town, North Shoa Ethiopia, from April 1 to May 1, 2021. The data were collected by using an interviewer-administered structured questionnaire. A total of 412 samples were selected by systematic random sampling method. The data were entered to EpiData version 3.1 and analyzed by SPSS. All independent variables were fitted into the binary logistic regression model to evaluate the degree of association and variables with a
p
value of <0.2 that was fitted for multiple logistic regressions. Finally, variables with a
p
value of <0.05 was found to be statistically significant. Result. A total of 412 workers were study participants with 100% response rate. The mean age was 29 (±7.3) years. Most workers, 367 (89%) knew that PPE can prevent work-related injury and illness. Overall, 172 (41.7%) of the workers were considered to have good personal protective equipment utilization. Perceived susceptibility (AOR = 1.2, 95%, CI (1.076–1.38)), perceived severity (AOR = 1.1, 95%, CI (1.088–1.163)), perceived self-efficacy (AOR = 1.2, 95%, CI (1.082–1.349)), and perceived barrier (AOR = 0.87, 95%, CI (0.800–0.956)) were found to be significant predictors of good personal protective equipment utilization. Conclusion. The study revealed that good personal protective equipment utilization in large-scale factory workers. Perceived susceptibility, perceived severity, perceived barrier, and perceived self-efficacy were found to be predictors of PPE utilization. It is recommended that, during delivery of health education special emphasis should be given to severity, susceptibility, barrier, and self-efficacy of occupational disease.