Kindu Yinges Wondie,1 Marta Berta Badi,2 Animut Tagele Tamiru3 1Department of Clinical Midwifery, School of Midwifery, University of Gondar, Gondar, Amhara Regional State, Ethiopia; 2Department of Women’s and Family Health, School of Midwifery, University of Gondar, Gondar, Amhara Regional State, Ethiopia; 3Department of General Midwifery, School of Midwifery, University of Gondar, Gondar, Amhara Regional State, EthiopiaCorrespondence: Animut Tagele Tamiru Email animuut@gmail.comBackground: The sharp fertility drop-off in the Amhara region between 2000 and 2011 was due to an increase in modern contraceptive utilization of rural women. However, long-acting contraceptive method utilization was higher among urban than rural women. Therefore, this study aimed to assess rural–urban differentials of long-acting contraceptive method utilization and the contributing factors among reproductive-age women in the Amhara region: analysis of the 2016 EDHS.Methods: The 2016 EDHS data were used. A weighted sample of 2188 (1675 rural and 513 urban) fecund reproductive-age women was used, and a mixed-effects logistic regression model was fitted. Multivariable logistic regression analysis at a P-value < 0.05 and adjusted odds ratio with a 95% confidence interval were used to declare significant associations.Results: The overall long-acting contraceptive method use was 13.3% (95% CI=11.6– 15.8), and it was 14.8% (95% CI=12.4– 17.2) among rural and 8.3% (95% CI=4.5– 12.4) among urban women. Among urban women, the odds of long-acting contraceptive method use was higher for women living with a partner (AOR=6.83; 95% CI=1.23– 37.84), married women (AOR=5.21; 95% CI=1.95– 13.89), women living in a male-headed household (AOR=5.29; 95% CI=1.26– 22.38), and women whose partner wanted fewer children (AOR=11; 95% CI=3.46– 16.2). Among rural women, the odds of long-acting contraceptive use was higher for women in the richest wealth index (AOR=6.69; 95% CI=3.02– 14.83), married women (AOR=30.26; 95% CI=8.81– 42.9), women with good knowledge of LACMs (AOR=1.75; 95% CI=1.25– 2.46), and women who had no correct knowledge of their ovulatory cycle (AOR=1.93; 95% CI=1.16– 3.19).Conclusion: Long-acting contraceptive method use was lower than the national target. LACM use was 8.3% (95% CI=4.5– 12.4) among urban and 14.8% (95% CI=12.4– 17.2) among rural women. Overall, marital status, educational level, the total number of children, knowledge of LACMs, and correct knowledge of the ovulatory cycle were significantly associated with LACM use.Keywords: Amhara region, comparative cross-sectional study, long-acting contraceptive methods