A major public health problem in developing countries including Ethiopia is related with poor sanitation and hygiene. Globally, over 2.5 billion people are still without access to improved sanitation. In 2010, 15% of the population still practice open defecation. The main objective of this study was to compare the latrine utilization rate and identify determinant factors among kebeles implementing and not implementing Urban Community Led Total Sanitation and Hygiene (UCLTSH) in Hawassa town. Comparative cross sectional study design was carried out in Hawassa town in 704 households in 3 kebeles undertaken UCLTSH and in randomly selected comparison 3 kebeles where UCLTSH was not implemented. Data entry and cleaning was undertaken by using EPI-info version 3.5.3 and analyzed using SPSS version 20. Multivariate logistic regression was used for independent variables with statistical significant association in bi-variate analysis. In this study, majority of the households 318 (90.3%) of UCLTSH implementers and 299 (85.4%) of non-implementers utilized latrines. The odds of latrine utilization were 1.59 times among households implementing UCLTSH compared with that among non UCLTSH [OR 1.59, 95% CI (1.00, 2.53)]. In relation to functional latrine, it was one of the factors affecting latrine utilization [AOR 28.26, 95% CI (13.03, 61.27)]. This study shows communities implementing urban community led total sanitation and hygiene was better in latrine utilization and having latrine facility than non-implementers. It is recommended that the town health office and municipality should expand the UCLTSH to other kebeles of the town.