Background: Higher level of autonomy of nurses' practices has a significant impact on patients, nurses, and hospitals in terms of improving the nurses’ satisfaction, motivation, and decreases their turnover, which enhances the patient perception of nursing care and satisfaction. Even though, autonomy is one of the cornerstones of nursing practice, yet there is limited study in Ethiopia, particularly Bahir Dar city. Objectives: This study aimed to assess level of nurses’ clinical practice autonomy and associated factors among nurse working in public hospitals of Bahir Dar, Northwest, Ethiopia, 2023. Methods: An institution-based cross-sectional study was conducted among 420 nurses working in Bahir Dar public hospitals from March 17 to April 10, 2023. Computer-generated random sampling technique was employed to select the study participants. Epi data version 4.6 and statistical package for the social sciences version 27 were used for data entry and analysis, respectively. Model fitness was checked by using the Hosmer-Lemshow goodness of fit test, and the overall p-value of the model was > 0.42. To identify the association, binary logistic regression was used and a p-value ≤ 0.05 was declared as statistically significant. The final findings were presented in tables, figures and a narrative description. Result: Among 420 nurses approached who are working in public hospitals in Bahir Dar, 407 responded to the questionnaire, making the response rate 96.9%.The prevalence of clinical practice autonomy was 55.3%. Having a master's degree (AOR = 7.43, 95% CI: 1.10, 10.03), working in intensive care units (AOR = 4.96, 95% CI = 1.54, 15.94), not engage in the nursing association (AOR = 0.57, 95% CI: 0.32, 0.99), intention to stay in the nursing profession (AOR = 3.13, 95% CI: 2.46, 6.94) and having low normative commitment (AOR 0.28, 95% CI 0.15, 0.50) were significantly associated with clinical practice autonomy. Conclusion and Recommendation: Nurses’ autonomy at work is impacted by not engaging in nursing associations and low normative commitment. Having a master's degree, working in intensive care units, and having intent to stay in the nursing profession had a positive relationship with nurses’ autonomy. In order to raise autonomy-related traits, nurses should update themselves, and hospitals and health care system employees should foster supportive settings. Key words: autonomy