Background: Iron folate supplementation for pregnant mothers is cost effective intervention reducing maternal and perinatal mortality. Despite the efforts to reduce iron deficiency anemia during pregnancy by providing iron folate supplement free of charge, only few women took an iron supplement as recommended Therefore determining level and associated factors of compliance with iron folate is initial step to improve compliance to iron folic supplementation among pregnant mother in study area and similar setting. Objective: The aim of this study was to assess the iron –folic acid supplements and associated factors among pregnant women attending antenatal clinic in Public health center of Shalla district, South West, Ethiopia, 2019 Method and Materials: Institution based cross-sectional quantitative study design was conducted among 402 pregnant mothers attending antenatal clinic, selected using systematic random sampling technique and using iron folate supplements in all public health center found in Shalla District, West Arsi Zone, Oromia Region. The collected data was analyzed using Epi data 3.1 and SPSS version 20 packages and relationship between compliance level to iron-folic acid supplementation and its associated factor was considered as significant at P values of <0.05. Results: Pill count compliance rate was found to be (154)38.3%. Pregnant mother who had anemia in their previous pregnancy (AOR = 11.35, 95% CI: 4.76-27.03), antenatal care during second trimester (AOR = 2.32, 95% CI: 1.12-4.81), counseling on iron-folate supplement (AOR = 11.39, 95% CI: 5.09- 27.03) and awareness on benefit of iron-folate supplement (AOR = 2.22, 95% CI: 1.18-3.92) were significantly associated with compliance to iron-folate supplement. Conclusions. Compared to World Health Organization cut of point pill count compliance rate of iron-folate supplementation among pregnant women in study area was very low. This study showed that pregnant mother with previous history of anemia, early antenatal care, counseling on iron-folate supplement and awareness on benefit of iron-folate supplement significantly affects compliance to iron folate supplement.