The purpose of this study was to assess the practice and challenges of cooperative training in some selected private health science TVET colleges in Addis Ababa City Administration. A descriptive quantitative and qualitative research design was adopted for this study. Data was obtained through questionnaire, interview and observation. Purposive sampling method was applied to select health science TVET college deans or vice deans. Sample trainee and trainers were selected first using stratified sampling to be able to include trainees and trainers participants from the departments available. Then proportionate sampling was employed to roughly ensure the representation. Among the distributed questioners, 218 (94.9%) trainees, 20(83.3%) trainers and 40(87%) health sector trainers (mentors) of the questionnaires were completed, returned, and used for the study. For the deans/vice deans and coordinators interview was used to collect the data. The major findings of the study indicated that, the health sectors awareness about the purpose of cooperative training system in Addis Ababa City Government with respect to: weak attention was given for cooperative training follow-up and monitoring; the availability and utilization of training contract, and memorandum of agreement in cooperative training providing health sectors was not satisfactory; training plan based on Occupational Standard is neglected. Finally, the study recommended that there should be a strong close supervision by the Health Bureau and TVET agency for the health TVET colleges and the health sectors to focus on cooperative training which can be improved through awareness creation of the benefits they could derive from the process