Background: Cervical cancer is one of the leading causes of morbidity and mortality amongst female cancer worldwide, especially in developingcountries, including Ethiopia. The level of women’s acceptance of cervical cancer screening and treatment service is low and not well documented in Ethiopia. The current study sought to assess women’s acceptance about cervical cancer screening and determinant factors of the service. Objective: The objective of this study was to assess the acceptability of cervical cancer screening and treatment of precancerous cervical lesions and determinant factors among Women aged 30–49 years at selected health centers in Addis Ababa, Ethiopia. Methodology: A facility based cross sectional study which contain quantitative and qualitative methods were conducted at 14 public health centers in Addis Ababa, from November, 2016 to October 2017.Totally a sample of 316 women aged 30–49 years were taken for Quantitative study and a single stage simple random sampling technique was employed to address the study subjects. For the Qualitative part 12 health professionals who were providing the service were interviewed purposively. Acceptability of cervical cancer screening and treatment service was measured after the women underwent the procedure, using women’s Satisfaction on service delivered.Descriptive, Binary and multiple logistic regressions were employed to determine factors associated with acceptance about cervical cancer screening and treatment service.The transcribed and translated qualitative data was coded using cut and paste method of similar item. Then finally the codes were categorized and thematically described. Result: one hundred forty seven (47%) of the participants accepted cervical cancer screening and treatment service. Almost half (48.6%) of the participant were not knowledgeable. After adjusting for covariates, acceptance of cervical cancer screening and treatment service was positively associated with being governmental employee [(AOR=5.85, 95% C.I:5.85(1.7, 20.0)], women who had history of vaginal burning [(AOR=4.57, 95% C.I:4.57(1.417,14.76)], information about status of women [ (AOR = 0.06,95% CI: (0.014,0.26)], Delay screening and treatment time [(AOR = 7.6,95% CI: 7.6(2.89,20)], happy with staff behavior,[(AOR =4.6, 95% CI: 4.6(1.1,19.77)], health education about the service [(AOR = 2.45, 95% CI: 2.45(1.049,5.74)] , and women who were happy with setup of examination room [(AOR = 3.96, 95% CI: 3.96(1.32,20.85)] respectively. Conclusion and Recommendation: This study shows a suboptimal acceptance of cervical cancer screening and treatment services. Occupational status, test related problem, Lack of health education, Delay screening and treatment time, setup of examination room and staff behavior were found to be important determinants. Efforts are needed to increase women’s acceptance and knowledge about the service. Organization working on cervical cancer should establish a separate service delivery on screening and treatment program and should highly enhancehealth education and awareness creation program.