Background: Among malaria control measures, use of mosquito nets is the one that is getting more acceptance and is being used in large scale worldwide. Despite on going distribution and use of nets in Ethiopia, the household level situation in utilizing them is by and large unknown. Objective: Assess utilization of mosquito nets in Serbo Town and clarify socio demographic, organizational, economical, behavioral and other factors related. Method: Qualitative and quantitative methods were used. In the Quantitative part, interviewer administered questionnaire with a checklist was used for a household. Qualitative section included focus group discussion of community members and in depth interview of important stake holders. Result: Malaria was recognized as a major problem. Children were said to be more effected groups, but did not intentionally get protection. Half of the households possess at least one net. Nets however, were not always used for the intended purpose. Common malpractices were selling, use as curtain and leave the nets in package. Main reasons were economical and unfavorable health belief. Factors that were independently associated with use were: possession of a radio, being knowledgeable, getting health education, number of persons per room and number of beds. Predictors of purchasing were occupation, possession of a radio and being knowledgeable. Discussion, conclusions and recommendations: Reasons for improper use were economical, housing condition, health belief, organizational effort and possibly biological. Selection of control measures, should take into consideration local situation. Once chosen as methods of prevention, mosquito net distribution should have proper guideline and local capacities for doing so should be strengthened. Education messages should focus on the need for prioritizing young children, possible use over sleeping floors and mending holes on nets using local material. Color and design of nets should take into consideration housing condition, and the trend of using for other purposes.