Background: In Ethiopia as in other developing nations, traditional bonesetters play a significant role in management of injury. There is widespread belief in our society that Traditional bone setters are better at fracture treatment than orthopedic practitioners. Traditional Bone Setting has a large place as an alternative health care despite modern health care's accessibility and availability. However, it is yet not well studied in Amhara regional state in general, in TGSH in particular. Objective: The objective of this study was to assess the proportion of patients with preference of traditional bone setting and associated factors among trauma patients attending orthopedic service at Tibebe Ghion specialized hospital Bahir Dar, northwest Ethiopia, 2022. Methods: Facility based cross-sectional study design was conducted on Four hundred five trauma patients at Tibebe Ghion specialized Hospital, Bahir Dar, from May 25 to June 25. The collected data was entered, cleaned, coded, checked, with Epi data and analyzed using SPSS version 25.00. Frequency tables and descriptive summaries was used to describe the study variables. Bivariable and multivariable logistic regression analysis was used. AOR, COR and with 95% CI was calculated. P-value of < 0.05 was used as a cut of point to declare statistical significance. Results: A total of 405 patients who had trauma attending orthopedic service at Tibebe ghion hospital, Bahir Dar were included in the study. The study revealed that 28.1% of respondents had preference of traditional bone setting for injury management. This study also showed that hospital admission status (AOR =4.351; 95%CI: 2.105, 8.996), Site of injury (AOR= 2.436; 95%CI: 1.216, 4.879), knowledge (AOR=2.812; 95%CI: 1.323, 5.954), and Perception (AOR = 0.025; 95% CI: 0.012, 0.052) were statistically significant with preference of traditional bone setting. Conclusion and Recommendation Despite an adequate number of orthopedic practitioners are available in the Hospital, traditional bone setters continue to be chosen. Hence striving on awareness creation on the need for facility-based management of trauma patients is recommended.