Background: Disclosure of HIV positive status to sexual partners, friends or relatives is a main tool for prevention and care strategies. Significant proportions of HIV positive adults never disclose their HIV positive status. Identifying factors associated with disclosure is necessary to freely disclose of HIV positive status result to their sexual partners, parents and friends to achieve a goal ‘zero new infection.’ Objective: This study was aimed to assess the HIV positive status disclosure and associated factors among HIV positive adults attending in Axum health facilities, Northern Ethiopia. Methods: Institutional based cross-sectional study was conducted from July - August, 2013 in Axum St. Marry hospital and Axum health center. After verbal consent was obtained data were collected by trained counselors and ART nurses using pre-tested structured questionnaire. Data were entered into SPSS version 16 databases. Bivariate and multivariable logistic regression models were used to identify associated factors for disclosure of HIV positive status at 95% confidence intervals and p-value of 0.05. Results: A total of 361 respondents were participated in the study of which gives 99.7% of response rate. The majority (80.1%) disclosed their HIV positive result to at least one person and among currently have sexual partner, 81.2% disclosed to their current sexual partner. marital status of the respondents, [(AOR = 3.70; 95% CI, 1.206 – 11.39)] knowledge of partner’s HIV status [(AOR= 3.43; 95% CI, 1.02– 11.5)] and member of Anti- HIV/AIDS association [(AOR = 4.81; 95% CI, 1.01 – 23.05)] had significant association with disclosure of HIV positive status. Conclusion: The rate of HIV positive status disclosure among HIV positive adults still continued to be low. Marital status of respondents, knowledge of partners HIV status, and a member of Anti- HIV/AIDS association were identified as predictors of HIV positive status disclosure.