Background: The provision of eye care services by trained and well-capacitated primary care providers in the rural community will contribute significantly to the reduction of avoidable blindness.Aim: This study aimed to investigate mid-level healthcare providers’ knowledge and skills capacity to provide primary eye care services.Setting: The study was conducted in four districts of southern Ethiopia.Methods: An institution-based descriptive cross-sectional study was conducted among randomly selected mid-level healthcare providers from August to October 2023. A self-administered questionnaire was used to collect data. Data entry and analysis were performed using Epi info version 6 and SPSS version 28 software. Descriptive statistics and logistic regression models were used in the analysis.Results: A total of 103 mid-level healthcare providers were involved in the evaluation with a response rate of 99%. Of the study respondents, less than half (48.5%) were found to have intermediate-level ability to provide primary eye care services. Serving more patients per month (p 0.001), receiving additional training (p 0.005) and having a first degree (p 0.001) were found to have a statistically significant association with the ability to provide primary eye care services.Conclusion: Most primary eye care service providers had a significant knowledge and skill gap. Capacity-building training aimed at enhancing the ability of primary eye care service providers need the appropriate attention.Contribution: This study presents the ability of mid-level healthcare workers to provide primary eye care services to support the elimination of avoidable blindness, resulting in improved quality of life.