Background: Epilepsy is one of the most common chronic neurological disorders with significant personal and social impact. Epilepsy mainly affects the younger age group. In children, trauma, central nerves system infections, genetic factors, prenatal events and perinatal events are all often identified as possible causes for epilepsy. Objective: To identify the risk factors for childhood epilepsy at health facilities of Hawassa city, Ethiopia, 2022. Methods: Facility based unmatched case control study was conducted in Health facilities of Hawassa city, Ethiopia. Cases and controls were epileptic and non-epileptic patients attending Hawassa university comprehensive specialized hospital and Adare general hospital from Feb-1 to Mar-31, 2022 G.C respectively. A total of 327 study participants (109 cases and 218 controls) were included in the study. Systematic random sampling method was used to select the study participants. Interviewer administered structured questionnaire was used for data collection. Data were checked, coded and entered in to Epi data 3.1 then exported to SPSS version 25 for cleaning and analysis. Descriptive analysis was done to summarize the findings. Bivariate and multivariate analysis was conducted using logistic regression. All the variables with p-value <0.25 were candidate variables for multivariable logistic regression analysis. Variables at p- value < 0.05 by multivariable logistic regression method were declared statistically significant. Result: The multivariate output showed that being male(AOR 1.978, 95%CI (1.013-3.864)) , being preterm(AOR 4.432, 95%CI (1.635-12.014)), having low birth weight(AOR 3.419, 95%CI (1.573-7.433)), urinary tract infection during pregnancy(AOR 2.983 95%CI (1.319-6.746)), history of febrile convulsion (AOR7.286 95%CI (3.370-15.752)) and family history of epilepsy (AOR 3.714, 95%CI (1.752-7.872)) were predictors for childhood epilepsy. Conclusion: This study identified male sex, preterm delivery, low birth weight, urinary tract infection and family history of epilepsy as predictor variables for childhood epilepsy. Most of these predictor variables could be minimized through community awareness creation and strong and integrated health care provision.