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Despite the recognized benefits, access to assistive technology (AT) remains limited. Identifying the current usage patterns and unmet needs of AT users could help address the challenges of students with disabilities. Thus, this study aimed to investigate AT use and its associated factors. An institution-based cross-sectional mixed study was conducted on higher education students with disabilities in Ethiopia. An interviewer-administered questionnaire and an in-depth interview technique were used to collect data. Descriptive statistics and binary logistic regression models were used to analyse the quantitative data, while inductive thematic analysis was undertaken for the qualitative data. A total of 233 (74.68%) with (95% CI: 70%–80%) students with disabilities used at least one form of AT. Four themes emerged which include experiences of AT use and disability, benefits and challenges of using AT, perception of the community towards AT, and responsibility for the provision of AT. Students with vision problems or those with severe disability types were most likely to be AT users. A significant proportion of students with disabilities had unmet needs for AT. Capacity at universities or rehabilitation centres would enhance access, usage of AT, and the unmet needs of students with disabilities. Will help to solve the barriers to accessing assistive technology and associated factors in the access and provision of assistive technology. Will help policymakers and stakeholders to design evidence-based rehabilitation strategies in the provision of assistive technology to persons with disabilities. Provide insight into the role of assistive technology in an educational platform to engage people with disabilities in education, improve their quality of life and lead them to become part of a productive society. [ABSTRACT FROM AUTHOR]