AbstractIntroductionPremarital sexual practice becomes a common phenomenon among youths in Ethiopia. It is usually associated with an unwanted pregnancy, abortion, and sexually transmitted diseases including HIV/AIDS.ObjectiveThis study aimed to assess the prevalence and determinants of premarital sexual practice among Ethiopian youths.Methods and MaterialsA Community-based cross-sectional study was conducted in all regions of Ethiopia from January 18 to June 27, 2016. All participants from the age of 15-24 (7, 389) were included for the analysis of the present study. Bivariable and multivariable binary logistic regression analytical models were fitted to identify factors associated with the premarital sexual practice. A 95% CI and p-value < 0.05 were used to declare statistical significance.ResultThe prevalence of premarital sexual practice was 10.8% (95% CI, 10 % – 11.5%). Being in the age group of 20 - 24 (AOR = 3.6, 95% CI (2.8, 4.6)), male sex (AOR = 1.7, 95% CI (1.3, 2.2)), employed (AOR = 1.4, 95% CI (1.03, 1.8)), from pastorals region (AOR= 1.4, 95% CI (1.3,2.4)), having mobile phone (AOR=1.7, 95% CI, (1.3, 2.3)), ever use of internet (AOR = 1.8, 95% CI (1.3, 2.5)), ever drinking alcohol AOR = 2.4, 95% CI (1.7, 2.5)), ever chewed khat (AOR = 2.4, 95% CI (1.6, 3.5), and ever tested for HIV (AOR = 1.3, 95% CI (1.1,1.6)) were a statistically significant factors associated with premarital sexual practice at p value less than 0.05.ConclusionFor every 10 youths at least one of them had sexual intercourse before they got married. Being in the age group of 20 - 24, male sex, employed, from a pastoral region, having a mobile phone, ever use of the internet, alcohol drinking, khat chewing, and ever tested for HIV were significant factors associated with the premarital sexual practice. Thus, national sexual education and reproductive health behavior change interventions should give due attention for those groups. Indeed, adequate education should be given about premarital sexual intercourse when youths come for HIV test.