Antenatal care (ANC), which is given to pregnant women, is widely used for prevention, early diagnosis and treatment of general medical and pregnancy-related complications. This study assessed the prevalence of early ANC visit and associated factors among pregnant women attending ANC in Debre Berhan town. An institution based cross-sectional study design was used to collect data from pregnant mothers with a face to face interview technique. Bivariate and multivariate analyses were used to identify associated factors for early ANC visit. A total of 446 pregnant women were included in the study. One hundred seventeen (26.2%) pregnant mothers started their first ANC visit early. The multivariate analysis showed that mothers with no parity before (AOR = 3.65, 95% CI: 2.14, 6.24), had good knowledge on early ANC (AOR = 3.10, 95% CI: 1.80, 5.33) and planned pregnancy (AOR = 1.66, 95% CI: 1.06, 2.61) were significantly associated with early ANC visit. The prevalence of early ANC visit was low. Awareness creation on the importance of early ANC visit needs to be emphasized at the time of service provision as well as at community levels.