BACKGROUND: Postnatal care is a key strategy to reduce maternal mortality. An early postnatal visit is a critical time for the survival of mothers and newborns. Despite the benefits, most mothers do not receive postnatal care services. Thus, this study was aimed to assess early postnatal care utilization among rural women and identify its associated factors.METHODS: Community-based cross-sectional study was conducted in the Horo Guduru Wollega zone from May 10 to 27/2019. A total of 695 randomly selected women participated in the study. A simple random sampling method was employed using the women's registration logbook. Multivariate logistic regression was used to control for possible confounders. A significance level of less than 0.05 was used in the final model to judge statistical significance.RESULTS: The magnitude of early postnatal care utilization was 21.8%. Multiple logistic regression analysis revealed that decision-making power, awareness about postnatal care, knowing at least one danger sign, place of delivery (AOR = 8.01), and model household (AOR = 5.65) were statistically significant.CONCLUSION: This study showed that the utilization of early postnatal care among rural women was found to be low. Decision-making, awareness about the danger signs, place of delivery, and graduating as a model household were the factors associated with postnatal care. Therefore, recommended that health facilities should work on increasing community awareness about the danger signs that can occur after birth or during the postnatal period and increase institutional deliveries.KEYWORDS: Postnatal, Utilization, Rural, Horo Guduru Wollega, Ethiopia