BackgroundHealth care seeking delay for tuberculosis suggestive symptoms is a great challenge for controlling the disease. Therefore, the study aimed to determine the magnitude and identify factors associated with delayed healthcare seeking among presumptive tuberculosis cases for suggestive tuberculosis symptoms. MethodsA community-based cross-sectional study was conducted among 476 subjects with symptoms suggestive of tuberculosis. Data were collected using a structured questionnaire, entered into Epi-data software version 3.1, and exported to SPSS software version 25.0 for analysis. The multivariable logistic regression models included variables like sex, marital status, knowledge, education level, and distance from health facility that show a significant association with health care seeking delay in the binary logistic regression at a P value 0.25. Tables, graphs, and charts were then used to display the results. ResultThe proportion of delayed health care seeking was found to be 46.7 % (95 % CI, 43.5–48.9). The study also revealed that being married, not attending formal education, having a lower monthly income, and having poor knowledge of tuberculosis were significantly associated with delayed tuberculosis-suggestive symptoms. ConclusionIn this study, delays in health care seeking among TB-suspected patients were high compared to the Ethiopian Ministry of Health target. Different systems should be built to increase community awareness of health care.