Background: Antenatal care is one of the key strategies for reducing maternal and neonatal morbidity and mortality directly through the detection and treatment of pregnancy related illness, or indirectly through detection of women at risk of complications of delivery and ensuring that they deliver in a suitably equipped facility. Low prenatal coverage, few visits, and delayed initiation of antenatal follow up are the pre-dominant problems throughout sub Saharan countries including Ethiopia resulting in failure of accomplishment of the world health organization recommendation. Objective: To assess the proportion and associated factors for late initiation of ANC at Tibebe Ghion Specialized Hospital, Bahirdar City, Ethiopia. Methods: Hospital based Cross sectional study was conducted among 411 Mothers who attend ANC from May 1 to September 1, 2021 at Tibebe Ghion Specialized Hospital, Bahir Dar City, Ethiopia. Study participants were selected with systematic random sampling. Pretested Questionnaire was used to retrieve information. The collected data was entered into Epi-data and then exported in to SPSS 23 for analysis. Bivariable and multivariable logistic regression analysis with 95% CI was computed to identify statistically significant associated factors with P value <0.05. Result: in this study 411 pregnant were participated resulted in one hundred twenty three (29.93%) pregnant women booked their first ANC late. The multivariate logistic regression analysis showed that pregnant women who had no knowledge About ANC and no primary education book ANC after four months of gestational age were increased. Conclusion: The prevalence of late booking for ANC was found still high in TGSH compared with WHO recommendation and the possible factors for this were lack of knowledge and no maternal formal education. To improve this addressing the identified factors by community mobilization and promoting the importance of early booking for ANC are mandatory. Keywords: Antenatal care; Late booking; Women; Bahirdar; Factors; proportion