Abstract Background Epilepsy is the most common neurologic disorder globally. Women with epilepsy (WWE) have a special need for contraception and careful pregnancy planning. This study aimed to determine the utilization of modern contraceptive methods and associated factors among WWE at neurology clinics in Addis Ababa, Ethiopia. Methods A cross‐sectional study was conducted on women of reproductive age attending neurology clinics for an epilepsy diagnosis at three referral hospitals in Addis Ababa, Ethiopia, from June to December 2020. Data was collected using a structured and pretested questionnaire administered by a trained interviewer. Simple descriptive analysis, bivariate analysis, and multivariable logistic regression were performed as appropriate. Results Only 29.7% of the women were using a modern contraceptive method. Contraceptive implants were the most popular method used (29.9% of contracepting women). Being married was associated with higher utilization of modern contraceptive methods [adjusted odds ratio [OR] (95%, confidence interval [CI]) 3.91 (1.80, 8.50)]. Women who were from an urban area [adjusted OR (95% CI) 0.29 (0.11, 0.78)], who had never been pregnant [adjusted OR (95% CI) 0.34 (0.17, 0.68)], and who had never been counseled on contraception [adjusted OR (95% CI) 0.47 (0.28, 0.78)] had lower odds of modern contraceptive method utilization compared to the respective counterparts. Conclusion In this study, only a third of WWE were using a modern contraceptive method. Marital status, place of residence, previous history of pregnancy, and history of family planning counseling were independent predictors of modern contraceptive utilization.
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