Background: Majority of the population in the WHO African region is still primarily reliant on polluting cooking options. Despite its adverse health impacts mostly respiratory illness, charcoal is still the preferred choice of fuel in households of Ethiopia due to its low cost, lack of availability, and fear of using modern fuels. In Ethiopia, there is a dearth of data reporting on the burden of respiratory illness among women using charcoal for cooking. Objective: The objective of this study was to assess the magnitude of respiratory illness among women households using charcoal cooking, its exposure, and its associated factors. Methods: A community-based cross-sectional study was conducted and women households primarily using charcoal for cooking were recruited. A pre-validated questionnaire and operational definition for respiratory illness were used to assess the respiratory illness among women. Bivariable and multivariable stepwise logistic regression model was used to identify factors associated with respiratory illness. Results: A total of 399 community-dwelling women households participated in this study. The mean age of the women participants was 32.9 ±10.2 years and ranged from 18 to 65 years. The overall cumulative prevalence of respiratory illness among women households using charcoal for cooking was 47.6% (95% CI 42.6, 51.9). The variable associated with respiratory illness were lack of formal schooling (AOR 2.56; 95% CI, 1.41-4.2), doing petty business at their house premise (AOR 2.01; 95% CI, 1.31 – 4.4), being house wife (AOR 3.8; 95% CI, 1.77 – 6.1), households with 7 & above family members (AOR 1.6; 95% CI, 1.01-3.34), lack of ventilation facilities (AOR 1.81; 95% CI, 0.99-3.0), and indoor cooking (AOR 3.21; 95% CI, 1.8-5.74). [ABSTRACT FROM AUTHOR]