Background: - Trachoma is still a widespread disease that causes blindness in many developing countries. Disease transmission occurs primarily between children and the women who care for them. There are currently 590 million people at risk from blinding trachoma, 150 million people with active trachoma, 10.6 million people with Trichiasis, and 5.9 million people with irreversible blindness due to trachoma. In Ethiopia the national blindness prevalence is estimated to be 1.25% and more than 900,000 persons are believed to be blind. Objective :- This study is designed to assess the prevalence of active trachoma among young children in relation to the implementation of SAFE strategy in their living area. Methods :- A comparative cross sectional study to assess the prevalence of active trachoma among young children, with a total of 1244 children included in the study. The sampling technique was multi-stage sampling by randomly selecting six kebeles from Ebinat woreda, and four kebeles from East Belesa woreda. The selected kebeles were divided into 144 villages, and among these 15 villages were selected by simple random sampling methods. 796 households with children under ten years in the selected villages were interviewed, and 1244 children were examined for the presence of active trachoma disease. This study took place between October and December 2004. Result In this study the prevalence of active trachoma in Ebinat woreda, where the SAFE strategy had been implemented, was 32%, and in East Belesa woreda, where the SAFE strategy was not implemented, prevalence was 56.9%. Awareness of the community for the preventions of trachoma in the area where SAFE strategy implemented was higher than non-implemented area. But in practice there were no differences except that face washing was more practiced in the area of SAFE strategy implemented. Conclusion The prevalence of active trachoma was lower in the area where SAFE strategy was implemented but it was higher in children residing in the area where SAFE strategy was not implemented. Infrequent face-washing habit was the strongest predictor of active trachoma. Recommendation Efforts should be concentrated on improving face-washing habit of children to reduce the magnitude of trachoma. Government and non-government organizations, planners and health policy makers should give a special emphasis for the role of SAFE strategy on trachoma control program.