Background: The intrauterine contraceptive device (IUCD) has long been recognized as a highly effective, long acting, reversible method of contraception. It is the second most commonly reversible contraceptive method used among married women of reproductive age in the world. However, in many developing countries, including Ethiopia, intrauterine contraceptive device use is at a very low rate compared to other modern methods. Objective: To assess factors affecting use of intrauterine contraceptive device method in Fagita Lecoma district, North West Ethiopia. Methods: Community based unmatched case-control study was conducted. The study was carried out in Fagita Lecoma district from December 5- 25/2015. A total of 296 study participants were included in the study with one to three cases to controls ratio. Cases and controls were selected by using simple random sampling technique. Structured questionnaire were used to collect the data. Epi info version 3.5 and SPSS version 20 statistical packages were used for entry and analysis. Result: A total of 74 IUCD and 222 short acting contraceptive method users of reproductive age women with 1 :3 cases to control ratio were included in the analysis. The mean age was 30.1 years (± 7 .89years) and 26.17 years (± 5. 76 years) for the cases and controls respectively. women choose their contraceptive method currently used by the help of others like health service providers and those who are age 35 and older were positively associated with use of IUCD as a method of contraception. With the odds of [AOR= 12, (95%CI) = (6.1- 23.5) and AOR=4.4, (95%CI) = (1.7- 11.1) respectively. On the other hand those women's who are agew ethnic group were negatively associated with use of IUCD as a method of contraception. With the odds of (AOR= 0.36, (95%CI) = (0.18- 0.71). Conclusion and recommendation: the study has identified women's ethnicity, who were choose your contraception method currently used and age as a major determinant for use of intra uterine contraceptive device. The health care system need to make a concerted effort to increase knowledge and attitude of reproductive age women's towards intra uterine contraceptive device as a family planning method.