Introduction: Alcohol use during pregnancy is a critical public health concern that is linked to several harmful maternal and fetal consequences in world wide. In developing countries especially in Sub- Saharan Africa, the prevalence of alcohol consumption during pregnancy is high. In Ethiopia, about 30% of pregnant women have consumed alcohol during pregnancy. There was no study tried to identify the knowledge of harmful effects of alcohol consumption during pregnancy in the study area. Therefore, this study was aimed to identify possible factors that result in alcohol consumption during pregnancy in the study area. Objective: The aim of this study was to assess proportion of alcohol use and associated factors among pregnant women attending antenatal care at Debre Tabor comprehensive specialized hospital May 1-30, 2021. Method: Institutional based cross-sectional study was conducted from May 1-30 by using systematic random sampling technique on 612 pregnant women attending antenatal clinic. The data was collected by face-to-face interview through semi structured questionnaires. The filled questionnaires were checked for completeness, edited manually and entered into Epi-data version 3.1 statistical software and then exported to Statistical package for social science version 25 windows for further analysis. A Binary Logistic regression model was used to analyze the data. Variables with P value 0.25 in the Bi-variable analysis were a candidate for multivariable analysis. Variables with P- value<0.05 in multivariable analysis were used as statistically significant associated factors. Adjusted odds ratio with 95% confidence interval was used to determine the degree of association between covariant and the outcome variable. Results: A total of 612 participants were included in the study with the response rate of 99.02%. The study showed that the prevalence of alcohol use among pregnant women was 26.3%. Factors like living in urban place [AOR=4.08, 95% CI, 2.23, 7.48], having no ANC follow up before survey [AOR=2.69, 95% CI, 1.37, 5.26], unplanned pregnancy [AOR=3.28, 95%CI, 1.88, 5.70], partner alcohol use [AOR=6.88, 95%CI, 3.92, 12.06] and having poor knowledge [AOR=2.26, 95%CI, 1.17, 4.33] were statistically significant associated factors with alcohol use during pregnancy. Conclusions and Recommendations: In this study, the prevalence of alcohol use during pregnancy was high as compared to the majority of other studies. The finding observed that living in urban place, having no ANC follow up before survey, having unplanned pregnancy, having a partner use alcohol and having poor knowledge were found to be statically significant associated factors with alcohol consumption during pregnancy. Factors associated with alcohol use during pregnancy are essential to reduce alcohol use and its health effect.