Background: The subjective clients’ care evaluation and media reports have rendered negative publicity and image regarding care in certain health institutions. Client satisfaction regarding provided care is one of determinant of quality care service. Today many health organizations strive to achieve high quality care to attract more clients. Objective: To assess client satisfaction and associated factors towards youth friendly reproductive health service among youth in Dessie Youth friendly clinics, North East, Ethiopia. Method: Institutional based cross sectional study in Dessie youth friendly clinics was conducted in 2016 Through systematic random sampling technique, 422 respondents were selected. Data entered to Epi Info after data cross checked manually and analyzed with statistical package for social sciences. Multivariable logistic regression analysis was used for the analysis. Odd ratio and 95% confidence interval was ascertain association between independent and dependent. Results: From the total 416 (98.6%) participants, 245 (58.9%) were satisfied with youth friendly reproductive health services. Associated factors for client satisfaction are: sex (AOR=2.33; 95% CI: 1.53-3.54), occupation of Self-employers (AOR=2.85; 95% CI: 1.55-5.25), have information (AOR=1.77; 95% CI: 1.16-2.71) and clients not comfortable with care providers (AOR=0.05; 95% CI: 0.00-0.32) had statistically significant association with satisfaction. Conclusion and recommendations: Client satisfaction of youth friendly reproductive health service in Dessie youth friendly clinics was low. Sex, occupation, information and comfort with care provider were the variables associated with satisfaction. Recommended to Dessie zonal health bureau, YFRHS to be accessible for students, Department head of youth friendly reproductive health service to give training for care providers on youth friendly service delivery approach of and communication Bureau of Dessie town to Sensitize youth about youth friendly reproductive health services with different Media.