Introduction: Pelvic organ prolapse is a major gynecological problem in developed and developing countries, which affects millions of reproductive age women and as well as menopause women. Even though the problem is outstanding, most private and asymptomatic nature of the illness makes POP the ―hidden epidemic‖ and the objective of this study was to identify the determinants of pelvic organ prolapse among gynecologic women‘s at public hospitals in Hawassa city, Southern Ethiopia Methods: Facility based unmatched case control study was conducted from June 15 to September 10, 2020 on 77 cases and 154 controls among women visiting public Hospitals for gynecologic service, 2020. All cases diagnosed with POP were enrolled in the study by using consecutive random sampling method by assuming that patient flow by itself is random until the required sample size was obtained. Then for each eligible case, two controls were selected consecutively at the same time immediately following the identified cases. A structured interviewer-administered questionnaire and chart review for type and degree of prolapse was used and data were coded, entered and cleaned in Epi-data version 3.1 and exported to SPSS version 20 for further analysis. Chi square test was conducted to check for having baseline difference in two groups. Then, binary and multivariable logistic regression analysis was employed and odds ratio with 95% confidence intervals (CI) was computed to identify determinants of POP Result: On multivariate logistic regression, heavy usual work load(AOR=2.3, CI(1.066-4.951), number of pregnancy ≥ 5(AOR=3.911, CI(1.108-13.802), birth space of <2 years(AOR=2.88, CI(1.146-7.232), history of fundal pressure (AOR=5.312, CI(2.366-11.927) and history of induced labor (AOR=4.436, CI(2.07-9.505) were significantly associated with POP with P value <0.05 and 95% CI after adjusting for potential confounders. Conclusion: among the variables studied, heavy usual work load (heavy load lifting), number of pregnancy/gravidity ≥ five, birth space of <two year, history of induced labor and fundal pressure during last birth were significant risk factors found to be associated with pelvic organ prolapse and taking preventive measures against those factors were recommended