Introduction: Episiotomy is the surgical enlargement of the posterior aspect of the vagina by an incision to the perineum during the last part of the second stage of labor. The rate of episiotomy is on the decline in developed countries but still remains high in less industrialized country. Studies are limited to show the extent of the problem and the reasons behind episiotomy practice. Objective: To assess the proportion of episiotomy practice and its associated factors among mothers who gave birth at public health institutions of Debark town Northwest Ethiopia 2021. Methods: Institutional based cross sectional study was conducted among 410 delivered mothers from April 1/2021 to June 30/2021. Systematic random sampling technique was used to select study participants. Data were entered to Epi data version 3.1 and exported to SPSS version 23. Variable with p-value < 0.25 during the bivariable analysis was considered for multivariable analysis. Stepwise backward elimination was applied for variable selection and model fitness was checked using Hosmer and Lemshows statistics test. Adjusted odds ratio with the corresponding 95% confidence interval was used to declare the statistical significance association of independent variables with the outcome variable. Result: Among the study participants the proportion of episiotomy was (42.9%). It was found that after the Multiple variable logistic regression: Face presentation (AOR =4.15; 95% CI (1.22,14.1) P=0.022), previous episiotomy (AOR=3.73; 95% CI (1.95,7.15); P < 0.001), short birth spacing interval (AOR=1.66;95% CI (1.01,2.73); P=0.044), perineal laceration (AOR=2.18; 95% CI (1.16,4.08); P=0.014) and induced labor (AOR=2.12; 95% CI (1.08, 4.14); P=0.028), were statistically significant at p-value <0.05 at 95% confidence interval . Conclusion and recommendation: The prevalence of episiotomy in this study area is high as compared with WHO recommendation (5-10%) and it’s more significantly associated with Face presentation, short birth spacing interval, induced labor, perineal tear and previous episiotomy. Therefore, judicious and timely episiotomy should be done for patients with Face presentation, short birth spacing interval, induced labor, perineal tear and previous episiotomy. So as to lower the increased risk of obstetric anal sphincter injuries and other complication in subsequent deliveries. But in the absence of benefit and with a potential for harm, a procedure should be abandoned. Key words: Episiotomy, Practice, Associated factors, proportion.