Back ground: Sub-optimal breastfeeding practices for children are the major cause of childhood illnesses and death. Globally, there are about 800,000 neonatal deaths by the reason of the late initiation and lack of exclusive breastfeeding. In developing countries, an estimated 13% of all child deaths could be prevented if optimal breastfeeding levels were achieved. Early initiation and exclusive breastfeedings are the key to child survival and the reduction of childhood mortality and morbidity. However, the literature is limited, therefore, this study aimed to assess the prevalence and factors associated with early initiation and exclusive breastfeeding in Assosa woreda, Northwest Ethiopia. Objective: This study aimed to assess the prevalence and identify associated factors with early initiation and exclusive breastfeeding among Mothers in Assosa Woreda. Method: A community-based cross-sectional study was conducted in Assosa Woreda from February to April 2021. A simple random sampling technique was used to select mothers with a child age 0-24 months old. Data were collected using interviews. Bivariate and multivariable binary logistic regression analyses were carried out to identify factors associated with early initiation and exclusive breastfeeding. Result: The mean age of mothers was 29 (±6.07 SD). The Prevalence of early initiation and exclusive breastfeeding was 72.8% and 54.5% respectively. The mother who visit Antenatal care visit (AOR= 3.003 (1.926, 4.683)), had adequate knowledge about breastfeeding (AOR= 3.378 (2.051, 5.562)) were more likely to practice early Initiation of breastfeeding. Mothers who initiate breastfeeding early (AOR= 2.239 (1.343, 3.732)), and had adequate knowledge (AOR= 2.229 (1.218, 4.080)) were more likely to practice Exclusive breastfeeding. Conclusion: The practice of early initiation and exclusive breastfeeding in the study area is suboptimal. Antenatal care visits and mother's knowledge about breastfeeding were significantly associated with Early Initiation of breastfeeding. Early initiation of breastfeeding and mother's knowledge about breastfeeding were significantly associated with Exclusive breastfeeding. Encouraging all mothers to receive ANC and Interventions should focus on the knowledge of mothers about breastfeeding were recommended.