Background: Abdominal obesity is emerging as a major contributor to the worsening of non-communicable diseases. There is a dearth of data on central obesity among adults in Ethiopia in general and in the study area in particular. The aim of this research was to determine the prevalence of central obesity and its predictors among adults in Nekemte, Ethiopia. Methods: Community-based cross-sectional study was conducted in Nekemte town from March to April 2020. Multistage sampling technique was used to select 466 study participants. Interviewer-administered structured questionnaire was used for data collection. The data were entered into Epi Data 3.1 and analyzed by SPSS Version 25. Bivariate logistic regression analysis was used to identify candidate variables at p < 0.25. Finally, multivariable logistic regression analysis was used to identify the independent predictors of central obesity at p < 0.05 with 95% confidence intervals. Results: Prevalence of central obesity in this study was found to be 28.4% (95% CI 24.5–32.6). Where, the prevalence was higher among females (37%) than males (18%). Being a female (AOR = 5.59, 95% CI 2.95–10.57), age range of 40–49 years (AOR = 4.91, 95% CI 2.17–11.13), ⩾ 50 years (AOR = 8.16, 95% CI 3.21–20.72), being in marriage (AOR = 9.306, 95% CI 4.23–20.44), highest wealth status (AOR = 7.94, 95% CI 3.76–16.76), consumption of fast foods (AOR = 3.022, 95% CI 1.375–6.64), and lack of knowledge about obesity (AOR = 3.39, 95% CI 1.93–5.95) were factors associated with central obesity. Conclusion: The study revealed a moderate prevalence of central obesity in the study area. Being a female, older age, being in marriage, richest household wealth status, consumption of fast foods, and lack of knowledge on obesity were identified as factors associated with central obesity. Comprehensive health education and promotion on healthy diet should be encouraged focusing on females, married individuals, and older ages.