Background: Exclusive breast-feeding is the practice of feeding breast milk during the first 6 months and no other liquids and solid foods except medications. Despite its demonstrated benefits, exclusive breast-feeding practice in many countries including Ethiopia is lower than the international recommendation. According to the WHO report, 38% of infants aged less 6 months are breastfed exclusively worldwide. The result of this study should be taken evidence for TGSH and also to implement interventions that speed up the government efforts and decrease the rate and burden of infant morbidity. Objective: The aim of this study was to assess exclusive breast feeding Practice and Associated Factors among mothers of 7 to 12 Months Old Infancy who visit Paediatrics Department Tibebe Ghion Specialized Hospital, 2022 Methods: An institutional based cross-sectional study was conducted among systematically selected 308 mothers whose have infancy age 7-12month from February 1, to March 30/2022. Data was collected through interviewer-administered structured questionnaire. Each filled questioner was checked for completeness and coded, and then entered into Epi Data version 4.6. Finally data was cleaned and exported into SPSS version 25 for analysis. Binary logistic regression model was employed to assess association of the variables and Multivariable Binary logistic regression Analysis was used to identify the association of independent variables on the outcome variable and those with P-value less than 0.05 will be taken as statistically significance. Results: A total of 302 study participants were enrolled in this study. About 188(62.3%) 95% CI (57%-68%) of mothers were Exclusive breast feeding for six months. Those who had information about Exclusive breast feeding (AOR=5.2; 95%CI: (2.33-11.45)), being housewife occupation (AOR=2.8; 95%CI: (1.4-5.6)), postnatal counselling (AOR=2.4; 95%CI: (1.4-4.2)), knowing importance of colostrum (AOR=2.82; 95%CI: (1.44-5.51)) were independent factors statistically significantly associated with Exclusive breast feeding. Conclusion and recommendation: In this study, 2/3 the infants were Exclusive breast feeding. Having information about Exclusive breast feeding, being housewife occupation, postnatal counselling and knowing importance of colostrum significantly associated with Exclusive breast feeding. Therefore, health education should be given about Exclusive breast feeding Key words: Exclusive breast feeding practice, Tibebe G