BackgroundIodine is one of the essential micronutrient components for healthy human life. However, it is deficient in household salt in most developing countries, like Ethiopia. This survey assessed the prevalence and risk factors associated with the adequacy of iodized salt utilization at the household level in Sawla town, southern Ethiopia. MethodsA community-based, cross-sectional study design was used. A multistage sampling technique was employed. Data were collected using a pre-tested and structured questionnaire through a face-to-face interview technique. Descriptive statistics was used to describe variables in tables and figures. A multivariable logistic regression model was applied to determine the final statistical associations between dependent and independent variables at a p-value of <0.05. ResultA total of 551 households participated in the survey, with a response rate of 97 %. A total of 243 (44.1 %) households were using adequately iodized household salt. There were reduced odds of utilizing adequately iodized salt when the main food handlers were in the age group 25–29 years, AOR (95%CI), 0.45 (0.22, 0.93), 35–39 years, AOR (95%CI), 0.37 (0.18, 0.77), ≥40 years, AOR (95%CI), 0.29 (0.14, 0.59), and among households who were using packed salts, AOR (95%CI), 0.33 (0.21, 0.52). Households who had a tradition of properly handling household salt to maintain its iodine content were more likely to use adequately iodized salt than its counter parts, AOR (95%CI), 1.9 (1.3, 2.78) and households who purchased salt from a retailer shop, AOR (95%CI), 2.82 (1.87, 4.24), were more likely to use adequately iodized salt than purchasing from an open market place. ConclusionsIn this study, adequately iodized household salt utilization was similar to regional levels across Ethiopia. The household’s salt handlers need to be empowered to have a tradition of proper salt handling, storage, and use practices.