Introduction: Globally, Cervical cancer is the greatest threat to women's health, which is the fifth cause of death accounting for all types of cancer deaths among women. Globally, 528000 new cases each year and the second most common in developing countries around 445,000 new cases develop cervical cancer each year. Cervical screening behavior is the recommended for effective methods for prevention and early detection of cervical cancer. To increase the awareness of cervical cancer screening behavior health education is pivotal in any prevention program aimed in reducing the overall prevalence of cervical cancer in the community. Objective: To assess cervical cancer screening behavior and associated factors among women attending gynecology out -patient department and maternal and child health at mettukarl referral Hospital, South west, Ethiopia, 2018. Methods: Institutional based cross-sectional study was carried among 321 patients. Systematic random sampling was applied to select study subject and descriptive analysis were employed to describe the percentages and number distributions of the respondents for socio-demographic characteristics. The data was collected through interviewing of respondents and the data was entered EPI data version 4.2 and analyzed by using SPSSS version 20.Bivariate analysis was also used to see the association of independent with the dependent variable. Crude and adjusted odds ratios with the corresponding 95% confidence intervals were computed. A P-value less or equal to 0.05 was considered statistically significant in this study. Result: In this study a total of 321 clients were participated in the study. The mean age was 35.79 with SD±11.46.The majority of participants 225(70.1%) were not intended cervical cancer screening while 96 (29.9%) were intended cervical screening respectively. Age ≥50 (AOR=26.603; 95% CI=8.167,86.662), age between 40-49 (AOR=4.152,95% CI=1.630,10.576), had smoking (AOR=0.179; 95CI=0.087,0.369), women’s who had STD AOR=0.169; 95% CI=0.82, 0.347), multiple sexual partner of the husband (AOR=1.221; 95% CI=0.687, 2.200) and were used contraceptive (AOR=0.172; 95%CI=0.070, 0.422)were found to have strong association with cervical screening behaviors. Conclusion and Recommendations: According to this finding, the overall rate of those participants who had good screening for cervical cancer behaviors were about 29.9%. Maternal age, using smoking, using contraceptives, presence of sexually transited disease, and having multiple sexual partner of the husband are predominantly stated factors associated with cervical screening behaviors.