Background: Ischemic heart disease is the leading cause of death worldwide accounting for almost 16% of all deaths. The contributing factors of cardiovascular diseases are multifarious and include smoking tobacco, hypercholesterolemia and diabetes. Timing of treatment is very critical in myocardial infraction patients primarily time of fibrinolysis and reperfusion. Objective – To determine the factors associated with time on arrival for patients with myocardial infraction at emergency department in Tibebe Ghion Specialized Hospital and Felege Hiwot Comprehenve Specialized Referral Hospital, 2022. Method- Institutional based cross-sectional study was conducted for Myocardial Infraction patients who visited Tibebe Ghion and Felege Hiwot Comprehenve Specialized Referral Hospital. The quality of the data was assured through careful design and pretesting of the tools, proper training of data collector. The results was displayed by using frequency tables and charts. The sample size was determined using computer-based Epi info7 software Stat Cal by using single population proportion formula with result of 303. Multiple logistic regression analysis was employed to control the possible confounding effect and assess the separate effects of the variables. A p-value of 0.05 and a 95% confidence interval were considered significant. Result- Total of 303 myocardial infraction patients were involved, the majority of patients were male (187; 61.72%). the mean time of myocardial infraction patients from onset of symptoms to admission in days was 5.83days. Low educational status, smokers, use of ambulance and public transport usage as well as visiting local pharmacy at onset of the initial symptom were significantly associated with Prehospital delay. Conclusion and Recommendations- The delay occurred more frequently in low educational status patient, smokers, use of ambulance and public transport as well as visiting local pharmacy at the onset of symptoms. There is need for mass commination to teach the people about the danger of myocardial infraction and how patients recognize it so that they may seek early treatment. Key words: Myocardial Infraction, Emergency Department, Tibebe Ghion Specialized Hospital, Felege Hiwot Comprehenve Specialized Referral