 This study found that 48.6% of pregnant women in Bahia Dar, Northwest Ethiopia started their first antenatal care visit within 16 weeks of gestation. Factors such as family size less than five, urban residents, secondary education or higher, being a primary graveder, having planned pregnancy, and knowledge about early initiation of antenatal care were associated with early initiation of antenatal care. This article was authored by Escahan Ambe, Zagai Wado Feregesa, and Gizor Haley.