As 19 core component of the broader health system of Ethiopia, Health Extension program (HEP) has heslth extension workers who are responsible for its implementation at the grass root levels. A program cannot be implemented without having human resource equipped with the required qualities. Working in a specific program, workers may face challenges and may have opportunities. Hence, the study at hand was designed with the overall objective to explore the challenges and opportunities of health extension workers in Dale Sadi Woreda of Oromia Region in the process of implementing the HEP. The study employed case study research design of qualitative approach to properly address the issue under study. The q.ualitative data collection tools applied in this study were interviews and observation. The interviews were conducted with twelve health extension workers and four key informants. The data collected through interviews were in some cas~"'! complemented by observation of HEW's physical environments at seven HPs in the woreda. The study employed thematic method of data analysis. The .findings of the study revealed that there are many practical challenges facing the HEWs of the woreda. Many of the challenges rooted in the lack of various actual and expected opportunities for the workers as much as they aspire. This study evidenced that the challenges are of multifaceted arising from limited education and trajning opportunities, narrow opportunity to work in one's own kebele, lack of transfer on request, lack of necessary facilities, the lack of supportive environment for the effective application of legal provision to fight harmful· practice, limited acceptance by the community, over workload and low self-perception. Despite its Iimitations. the availability of continuing education and training opportunity since 2011112 has been identified as an opportunity for the HEWs. In order to ensure better performance and personal development of the HEWs, the challenges should be addressed and the horizon of opportunities should be broadened for them.