Background: Birth preparedness and complication readiness (BPCR) is a key component of globally accepted safe motherhood programs, which helps ensure women to reach professional delivery care when labor begins and to reduce delays that occur when mothers is in labor& experience obstetric complications. Objective: To assess the magnitude and factors associated with birth preparedness and complication readiness among pregnant women attending antenatal care services at public health facilities in Debrebirhan town, Amhara, Ethiopia, 2015. Methods: Cross-sectional facility based study was used. The required sample size was 356. The collected data was coded and entered to Epi-Info version 3.5.1 and transferred to SPSS version 20 for analysis. Binary and multiple logistic regression analyses were conducted. Results: Only 53.9% with 95% CI (48.9, 59.0) of the respondents were well prepared for birth and its complication. Variables having statistically significant association with BPCR of women were knowledge of BPCR (AOR = 2.08, 95% CI = 1.16, 3.73), PNC follow-up (AOR 2.79, 95% CI=1.73, 4.48) and early ANC visit (AOR = 2.06, 95% CI = 1.11, 3.83). Conclusions: The finding of this study showed that it is not enough to bring positive change for preparedness of birth and its complication. Knowledge on BPCR planned PNC follow-up, and early ANC follow up were independent factors of birth preparedness and complication readiness.