Background: Antenatal care (ANC) is a health care service provided by skilled health care professionals for pregnant women from conception to the onset of labor. ANC is widely used for prevention, early diagnosis and treatment of general medical and pregnancy-related complications. ANC is recommended to start within the first trimester but, acceptable until 16 weeks of gestation in Ethiopia. However, according to Ethiopian Demographic Health Survey (EDHS) 2016, 80% of women were late at their first ANC visit. But, there is insufficient information in the study area regarding the prevalence and factors associated with late ANC visit. Objective: To assess the prevalence of late antenatal care booking and its associated factors among pregnant women attending in Hawassa Public Health Facilities, South Ethiopia, 2019. Method and materials: Institutional-based cross-sectional study was employed from June 15-August 15, 2019. A total of 392 pregnant women were included in the study. Data were collected using semi-structured and pre-tested questionnaires. Data were entered into EpiData version 3.1 then exported to SPSS version 24 for analysis. The finding of this study was presented using tables, graphs and charts. Finally, Variable at p-value <0.25 on bivariate analysis was taken in to multivariable logistic regression to found factors significantly associated with late ANC booking at a P-value of < 0.05. Results: The prevalence of late antenatal care visit was 57.7 % (95% CI=52.74-62.57%). Maternal age groups, 31-35 years (AOR=4.93, 95% CI=1.70-14.27) compared to 16-20 age groups, Husband with no formal education (AOR=2.88,95% CI=1.17-7.314), attained primary education (AOR=3.12,95% CI=1.63- 5.99) and secondary education (AOR=1.97,95% CI=1.14-3.41) compared with the tertiary level of education, no previous ANC (AOR=2.03, 95% CI=1.20-3.43), absence of previous obstetric complications (AOR=4.05, 95% CI=2.06-7.96), Unplanned pregnancy (AOR=2.40,95%CI=1.23-4.68), and pregnant women unsupported by partner (AOR=2.47,95%CI=1.16-5.26) were significantly associated with increased odds of late ANC booking. Maternal decision making for service (AOR=0.40,95%CI=0.18-0.87) compared with decision made by husband were significantly associated with decreased odds of late ANC booking. Conclusion and recommendation: late booking for ANC was high in the study area. Maternal age, husband level of education, previous ANC visit, previous obstetric complications, type of pregnancy, maternal decision making and partner support were significantly associated with late ANC booking. The City’s health offices needs to provide education about danger sign of pregnancy and its complication, create awareness about the importance of early ANC booking and its recommended time.