Abstract Background: The Advanced Trauma Life Support (ATLS) protocol is a globally recognized system aimed at improving the care of trauma patients by ensuring timely and effective interventions for their stabilization. Despite generally positive attitudes among healthcare workers, evidence from African studies shows significant gaps in ATLS knowledge and practice. Only small percent of emergency care providers in Bahir dar take formal ATLS training but it is incorporated in trauma teaching books. Objective: This study aims to assess the knowledge, attitudes, and practices of emergency care providers regarding the ATLS approach in tertiary hospitals of Bahir Dar City, Ethiopia, September 2025 to February 2026. Methods: Institutional based analytical cross-sectional study was conducted Qamong healthcare workers who were working in Tibebe Gion Comprehensive specialized hospital and Felege Hiwot Comprehensive Specialized Hospital Bahir Dar, Ethiopia. Total sample size was 202. Stratified systemic sampling technique was employed. A structured self-administered questionnaire was used for data collection. The data were collected using kobo collect and analyzed with statistical package for social science version 27. Logistic regression analysis was used to differentiate the effects of each independent variable on the dependent variable. Results: Among 190 study participants with 94.1 % response rate most (118) (62.1 %) had poor knowledge towards ATLS. More than half (102) (46.3 %) had negative attitude and (110) (57.9 %) had poor practice. Being a senior or resident (AOR 0.05(0.01,0.256) p<0.01), having > 5 years’ experience, seeing more than 6 patient per week, age between 20-30 and ATLS training (AOR 0.352(0.131,0.95) p0.039) increased odds of having good knowledge. In addition, having advanced trauma life support training contributes to positive attitude. Having good knowledge and positive attitude contributes to better practice. Conclusion: The important determinant was ATLS training, as trained and young providers showed significantly better knowledge. The absence of training in ATLS was the main determinants of poor knowledge, and poor knowledge combined with a negative attitude was associated with poor practice.