Background: Exercise prescription (EP) use as medicine is an effective. It is the cornerstone to prevent and manage NCDs. The main aim of the study was to investigate the knowledge and confidence, practice of HCPs towards NCDs pertaining to EP in West Gojjam Zone hospitals, Amhara region, Ethiopia.Methods: The target population was 487 HCPs (medical doctors, nurses and midwiferies).Cross sectional research design was carried out in hospital setting from HCPs to collect data, Self-administered questionnaires were used from 7 governmental hospitals and 353 HCPs (Medical doctors=107, 30.3%, Nurses=157, 44.5% and Midwiferies=89, 25.2%) was selected through whole, strata and random sampling methods. The data was collected and analyzed from March, 2021- June, 2012. It was analyzed through descriptive (mean, frequency, percentage, cross tabulation and standard deviation) and inferential statics(chi-square, Kruskal-Wallis test of analysis, Mann-Whitney U test to examine difference and spearman’s rank to examine correlation). All assumptions for conducting non-parametric tests were used before decided to use the type of statistical data.Results: The HCPs reported that; majority of 80.6% respondents had poor EPP regarding to written prescription for their patients. 62.5% of HCPs were agreed they had not knowledge on WHO and ACSM recommendations to prescribe exercise for NCD patents. Male HCPs were had better exercise prescription practice ( x2 = 228.756, df = 15, p =0.000 ). HCPs knowledge and confidence was had a significance difference regarding to profession (Medical doctors: Mean rank =198.71, Nurses: Mean rank =171.96 and Midwifery: Mean rank =159.78, x2 = 7.773, df = 2, p =0.021). Exercise prescription practice (EPP) was significantly and positively correlated with Knowledge and Confidence (rho=0.292, p= 0.000). EPP was had a positive and significant correlation with all main variables of the study.Conclusion: Exercise prescriptions practice, knowledge and confidence of majority of HCPs regarding to prescribe exercise for NCDs were poor. The HCPs educational curriculums should include sufficiently about physical exercise as a strategy how to prevent and manage NCDs. Exercise is medicine Ethiopia (EIME) initiative should established and Exercise Prescription (EP) also established in organizational structure as a unit in healthcare setting. There should be a standardized recommendation guidelines, prepared at a national level to prescribe exercise used as a bench mark for healthcare providers for every healthcare settings. There will be also design a continuous training program for HCPs to be a role model or how to prescribe physical activity or exercise to prevent and manage NCD from their patients.