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Background: Neck pain is the major cause of morbidity and absenteeism from university lessons among medical students worldwide. Medical students are more exposed and appear to have neck pain because of their length of study to achieve their professional goals. However, up to the knowledge of the researcher, there is a scarcity of literature conducted on prevalence and associated factors of neck pain among medical students in Ethiopia. Therefore, the aim of this study was to determine the prevalence and factors associated with neck pain among medical students at Mekelle University, College of Health Sciences, Tigray, Ethiopia., Method: Institutional based cross-sectional study was conducted from April 2018 to May 2018. A structured questionnaire adapted from the Nordic musculoskeletal questionnaire was distributed to 422 participants using a self-administered questionnaire in Mekelle University, College of Health Sciences Tigray, Ethiopia. Independent variables which had a significant association were identified using logistic regression models. Results were reported by using texts and frequency distribution tables., Result: A total of 422 participants involved in this study, with a 99.3% response rate. Previous 12 months self-reported prevalence of neck pain among medical students was found to be 49.2% with 95%CI (44.5-54%). Previous history of neck pain (AOR: 11.811, 95%CI: 5.460-25.549), physical exercise (AOR: 2.044, 95%CI: 1.233-3.387), duration of reading (AOR: 1.502, 95%CI: 0.236-2.780) and awkward posture (AOR: 3.87, 95%CI: 2.311-6.484) were factors significantly associated with neck pain., Conclusion and Recommendation: The current study showed that nearly half of the study participants self-reported to have suffered neck pain in the preceding 12 months. Past history of neck pain, physical exercise, duration of reading and awkward neck posture are likely to be significantly associated neck pain among medical students in Ethiopia. Engaging in consistent physical exercise has a protective effect against neck pain. Therefore, Medical students are recommended to carry out a regular physical exercise for a minimum of twenty to thirty minutes per day.