This study aimed to assess the prevalence of occupational injury and associated factors among building construction workers in Dessie town, Northeast Ethiopia.The prevalence of occupational injury was 32.6% 95% CI (27.8-37.4). Male workers [AOR: 1.775, 95% CI (1.108-2.844)], uneducated [AOR: 3.327, 95% CI (1.262-8.771)], training [AOR: 2.053, 95% CI (1.004-4.195)] and Uses of PPE [AOR: 2.076, 95% CI (1.253-3.439)]. In focus group discussions negligence of the workers and lack of awareness were factors significantly associated with Occupational injury. The occupational injury was high among construction workers. Sex, Educational status, Safety training, Personal protective equipment were statically significantly associated.