Background <p>Maternal health services were among the services provided by health extension workers, but the utilization of these services remains inadequate in Ethiopia. Therefore, this study aimed to study women’s satisfaction and related factors with health extension service in Hawassa City, Sidama region, Southern Ethiopia.</p> Objective <p>This study aimed to assess women’s satisfaction with health services provided by health extension workers and its associated factors in Hawassa City.</p> Method <p>A community-based cross-sectional study was conducted from August 1/2022 – September 1/2022 in Hawassa city. A multistage sampling technique was used to allocate 363 study participants. Data were checked for completeness and consistency, then, coded and entered into Epidata version 4.6, exported to the SPSS, IBM version 26. Descriptive statistics was used to describe the study variables. In the bivariable analysis, variables with P-Value &lt; 0.25 were considered candidates for multivariable analysis, and significance was declared at P-Value &lt; 0.05.</p> Result <p>From 355 samples, 353 women participated in the survey with a 99% response rate. The overall proportion of women satisfied with health extension services was 51.8% with a 95% CI (46.9–56.8%). Two hundred fifty-nine (73.4%) of mothers used family planning services and 248(70.3%) participants were exposed to Maternal and child health services. Above secondary education AOR = 2.4; 95% CI (1.1–5.1), Husband occupation AOR = 15; 95% CI:7–33) and being model family AOR = 2.43; 95% CI:1.02–5.6) had higher odds of satisfaction with health extension services.</p> Conclusion <p>In the research area, women’s satisfaction with health extension services was low compared to other national studies. A husband’s job, having a better education, and being a model household were all positively correlated with their level of satisfaction. To maximize women’s satisfaction training and certifying model households was essential.</p>