Cervical cancer remains a major cause of morbidity and mortality among women, particularly in low-resource countries like Ethiopia. Early screening for pre-cervical cancer is a key intervention in reduction of maternal deaths. We assessed uptake of pre-cervical cancer screening and its associated factors among women of reproductive age in Debre Markos town in northwest Ethiopia.A community-based, cross-sectional study was conducted among 517 women of reproductive age. A multistage sampling technique was used to select study participants. Kebeles (sub-districts) were selected by a simple random sampling technique.Data was entered using Epi Info and analyzed by SPSS. Variables in binary logistic regression with a P value < 0.2 were fitted to multivariable logistic regression. Significant variables were declared at 95% CI and an AOR of P value < 0.05.A total of 517 women were interviewed with100% response rate. Results revealed only 108 women (20.9%) [95% CI =17.6-24.6] had been screened for pre-cervical cancer. Participants ages 35-49 [AOR = 3.21, 95% CI: 1.40, 7.39] informed by health professionals about cervical cancer [AOR = 6.65, 95% CI: 3.64, 12.15], positive attitude to screening [AOR = 3.38, 95% CI: 1.92, 7.61], visited health institution once or more in a year [AOR = 6.72, 95% CI: 2.40, 18.79], visited health institution once or more in two years [AOR = 3.76, 95% CI = 1.39, 10.19], history of sexually transmitted infections [AOR = 2.37, 95% CI: 1.11, 5.07] and family history of cervical cancer [AOR = 4.95, 95%CI: 1.62,15.15] were significantly associated with pre-cervical cancer screening.Uptake of pre-cervical cancer screening was found to be low among women of reproductive age. Age, attitude, informed by health provider, visiting health institution, history of sexually transmitted infections and family history of cervical cancer were found to be significantly associated with higher uptake of screening. To scale up currently limited uptake of pre-cervical cancer screening, community health education should be undertaken, leading to attitude change for young women.