ObjectiveThis study aimed to assess the prevalence of delayed treatment seeking and its associated factors among patients with malaria in the Andabet district, Northwest Ethiopia, 2022.DesignAn institution-based cross-sectional study was conducted from 8 July 2022 to 21 August 2022. Data were collected from malaria patients using structured and pretested questionnaires and entered using Epi data V.4.6 and analysed by using Stata SE V.14. Both bivariable and multivariable logistic regression analyses were used to identify the factors associated with delay seeking treatment among malaria patients. P values less than 0.05 with 95% CI and adjusted OR (AOR) were considered statistically significant.SettingThe study was conducted in the Andabet district, Northwest Ethiopia.ParticipantsA total of 403 malaria patients participated in this study. The sample was allocated proportionally for the six health centres and participants were selected through systematic random sampling techniques.Outcome measuresThe primary outcome is the prevalence of delay in seeking malaria treatment.ResultsA total of 403 malaria patients with a mean age of 27.6±SD 14.26 years were included in this study. The prevalence of delayed malaria treatment seeking was 78.41% (95% CI 74.11%, 82.17%). Do not know the cause of malaria (AOR=2.24, 95% CI (1.07, 4.65)), do not know malaria signs and symptoms (AOR=2.52, 95% CI (1.04, 6.07)), distance greater than 5 km travelled (AOR=5.37, 95% CI (1.22, 23.55)) and fear of treatment cost (AOR=1.88, 95% CI (1.05, 3.36)) were the statistically significant factors associated with delayed treatment seeking among malaria patients.ConclusionsThe prevalence of delayed malaria treatment was high. Lack of knowledge of the cause of malaria, lack of knowledge of malaria signs and symptoms, a distance greater than 5 km travelled and fear of treatment cost were significantly associated with delayed malaria treatment seeking. Therefore, community awareness of early treatment is crucial.