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Seid Jemal Mohammed,1 Woiynshet Gebretsadik Kelbore,2 Gesila Endashaw Yesera,2 Mulugeta Shegaze Shimbre,3 Kenzudin Assfa Mossa,4 Keyredin Nuriye Metebo,1 Yibeltal Mesfin Yesgat1 1Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia; 2School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 3School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 4Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, EthiopiaCorrespondence: Seid Jemal Mohammed Email seidovjemal@gmail.comBackground: The postpartum intrauterine contraceptive device (PPIUCD) is an effective, reliable, safe and recommended contraceptive method for the postpartum women. However, only a small proportion of women who gave birth at health facilities in the world have used it. There are limited studies about determinants of PPIUCD utilization. Therefore, this study aimed to assess determinants of postpartum IUCD utilization among mothers who gave birth in Gamo zone health facilities, southern Ethiopia.Methods: A facility based unmatched case-control study was done at Gamo zone public health facilities, southern Ethiopia. Data were collected using a pretested interviewer-administered questionnaire from March 1 to April 15, 2019. The data were coded, cleaned and entered into Epi-Info version 3.5.1 and exported to SPSS version 25 for advanced analysis. Binary logistic regression was performed to identify the determinants of PPIUCD utilization.Results: A total of 510 (175 cases and 335 controls) participants were involved in the study yielding a response rate of 95.1%. Partner support for IUCD insertion (AOR [95% CI]: 10 [4.03, 24.3]), birth interval (AOR [95% CI]: 9.7 [1.7, 55.1]), fertility plan (AOR [95% CI]: 4 [1.44, 10.84]), and timing of counseling (AOR [95% CI]:1.25 [0.034, 0.46]) are the determinant factors for postpartum IUCD.Conclusion and Recommendation: Birth interval, fertility plan, timing of counseling, pregnancy plan and partner support were the determinant factors identified in this study. Therefore, counseling of both partners during antenatal follow-up, delivery and immediately after delivery by health professionals are recommended.Keywords: postpartum intrauterine contraceptive device, PPIUCD, Gamo zone, unmatched case control, determinant factors