Back ground A precancerous cervical lesion is a cluster of precancerous cells on the cervix surface that are unique from normal cells and eventually develop in to cervical cancer. Periodic and early diagnosis of lesions can help avoid cancer. Cervical cancer is that the second leading cause of mortality in Ethiopia. Cervical cancer and human immunodeficiency virus are major public health issues and co-morbidities majorly in SSA, like in Ethiopia. And studies on the proportion of precancerous cervical lesions and predictors in HIV infected and uninfected women are almost non-existence, especially within the current study environment. Objective: To assess the prevalence and associated factors of pre-cancerous cervical lesions among HIV-infected and HIV-uninfected women at health institutions in Bahir Dar city, Ethiopia/2022. Method: A health institutional based comparative cross-sectional study design was conducted from Maye 15 to June 27, 2022, in Bahir Dar City. Data were collected from 366 HIV infected and 366 HIV uninfected using interviewer-administered structured questionnaire. Participants were selected by using systematic random sampling technique Data were coded, entered, and cleaned by used EPI data and exported to SPSS version 26. Following binary and multivariable logistic regression analysis were used to identify factors associated with precancer cervical lesions. Finally, P-value of <0.05 was considered statically significant predictors with precancer cervical lesion. Results: In this study, the proportion of pre-cancerous cervical lesion was higher in HIV- infected 16.5% (95% CI: 12.7, 20.5) than HIV-uninfected women 9.4% (95% CI: 6.5, 12.4). women who had illiterate (AOR =6.39:95% CI (2.92, 13.98)), HIV infected (AOR =1.93:95% CI (1.11, 3.37)), initiated sexual intercourse before 18 years were (AOR = 2.67: 95% CI (1.55, 4.59)), sexual transmitted disease (AOR =3.70:95% CI (2.14, 6.14)), multiple sexual partners (AOR =3.05:95% CI (1.76,5.29)) were statistically significant with precancer cervical lesion. Conclusion: During this study, support the hypothesis that being HIV infected has statistically correlated effect with magnitude of precancer cervical lesion and therefor the risk of it. In order that it should Government and stakeholders should give high priority for Precancer cervical lesion, youth friendly service and condom promotion. Key words: Precancer cervical lesion, HIV infected and uninfected, Bahir Dar, Ethiopia