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Purpose: Eating contaminated food continues to cause numerous food-borne diseases globally. Understanding the causes of poor food safety practices is key to preventing food-borne diseases. Therefore, this study aimed to assess the prevalence of food safety practices and associated factors among health extension model and non-model households in Kombolcha, Ethiopia. Methods: A comparative cross-sectional study was conducted among 327 model households and 329 non-model households in Kombolcha. Four kebeles were selected randomly from a total of 12 kebeles, followed by a systematic random sampling method to select a total of 656 households. The data were collected through face-to-face interviews with household heads and observations from April 15 to May 15, 2021. Data were entered into EpiData version 3.1 and analyzed using SPSS version 25.0. Determinants of food safety practices were determined by using multivariable logistic regression model at a p-value < 0.05. Results: The overall prevalence of food safety practices was 44.7% (95% CI: 40.5– 48.4%), of which 57.8% (95% CI: 53.0– 63.1%) were model and 31.6% (95% CI: 26.5– 36.7%) were non-model households, with significant variation among household types. Being a model household (AOR=2.99; 95% CI: 1.98– 4.52), having a female household head (AOR=3.13; 95% CI: 2.13– 4.59), proper solid waste management (AOR=2.32; 95% CI: 1.54– 3.48), good knowledge of food safety (AOR=2.05; 95% CI: 1.43– 3.03), and good attitude (AOR=1.74; 95% CI: 1.22, 2.49) were significant predictors of good food safety practices. Conclusion: The prevalence of good food safety practices was not satisfactory. Being a model household, having a female household head, proper solid waste management, good knowledge, and good attitude were significantly associated with good food safety practices. Therefore, the identified modifiable factors are potential areas of intervention to enhance good food safety practices. [ABSTRACT FROM AUTHOR]