Nowadays, fecal sludge management (FSM) is a global concern, particularly in lowincome countries which predominantly rely on on-site sanitation technologies. That’s why, in poor and growing urban areas of those low-income countries like Ethiopia, fecal sludge management represents a growing challenge; generating significant negative public health and environmental risks. Thus, this study was carried out to investigate the current fecal sludge management situations in Kombolcha town. To address the research objectives, household surveys, field observation, focus group discussions, key informant interviews, and relevant document reviews were used. For credible preliminary data analysis, SPSS and Micro Soft Excel were used and followed by Shit Flow Diagram (SFD) analysis. The SFD methodology was primarily used to highlight the extent of problems or gaps in an existing fecal sludge management situation. Following SFD results, public health hazards and community perception assessment has been conducted for the comprehensiveness of the study. The study identified 75.7% of households rely on shared toilets with two and above households. Five main toilet technologies of households were also identified in Kombolcha town: Cistern flush toilets - 2.1%, Pour/manual flush toilets - 19.8%, Ventilated Improved Pit latrine (VIP) – 11.1%, Pit latrine with and without slab (56.4% and 10.7% respectively). However, only 37% of households were experienced in a pit/tank filling up and emptied their facility to reuse again. The final SFD result presented 56% of fecal sludge safely managed and 44% unsafely managed. While 76.5% of fecal sludge contained and 16.5% not contained on-site. Issues arising out of health risk exposure valuation identified pit/tank overflow occurrences, poor children feces management, open defecation practices, and indiscriminate fecal sludge or black water discharges as a primary source of health hazards. Furthermore, the study identified the inhabitant‘s remark; the need for subsidies, additional construction and/or rehabilitation of existing public and communal toilets, enforcement of sanitation bye-laws as well as proper supervision, inspection, and monitoring of sanitation facilities and services so as to improve the present fecal sludge management practices.