Introduction: Adolescents in Ethiopia face many health problems which emanate from low knowledge and awareness of their reproductive health, though there are additional factors contributing to the problem. Provision of adequate, friendly and quality reproductive health services to this group of young people is vital to have healthy and productive generation. This systematic review aimed to assemble the top obtainable evidence for the determinants of adolescent reproductive health services utilization in Ethiopia.

Methods: Systematic review of literature searches in major databases, MEDLINE, CINAHL, EMBASE, and Popline was conducted. English language articles published from 2010 onwards were sought. Socio-demographic and behavioral related outcomes were our interest. Fixed effect model with mantel Haenszel method was used to conduct meta-analysis using Revman5 software. Records were assessed for eligibility by two independent reviewers, with a third reviewer resolving disagreements.

Result: Four community-based cross-sectional studies were included in the review. Results of the meta-analysis showed that adolescents whose educational level was primary were 57% less likely to use Reproductive Health services than adolescents whose educational level was secondary and above. In-school adolescents were 2.39 more likely to utilize Family Planning services than adolescents who were out-of-school. Moreover, adolescents who ever discussed on Reproductive Health issues with relatives/family/health workers were 3.63 more likely to utilize the services than adolescents who didn’t discuss with anyone else.

Conclusion: We found adolescents’ educational level; schooling status and ever discussion on reproductive health issues were associated with Reproductive Health service utilization in Ethiopia. Health information/education should be given in a regular manner to adolescents in schools and out of school on the availability and need for reproductive health services. Developing the culture of discussion on Reproductive Health issues within the community may help adolescents to be aware and utilize the available services.

Keywords: Adolescents, Ethiopia, factors, reproductive health, utilization