Back ground: Alcohol is one of the most psychoactive substances used by adolescent and youth. Alcohol use above the standard level and even if in the standard level leading different adolescent and young population public health problem. More than 200 health problem can occur due to alcohol use. Adolescence and youth age group are the most active population for decision making and begin alcohol use early. This study was conducted to address how much of the school age population use alcohol and what are the risk factor that leads to use alcohol in this study area. Objectives: Objective of this study was to assess alcohol use prevalence and its associated factors that lead to use alcohol among secondary and preparatory school students in Mehal Meda 2019/20. Methods: School based cross-sectional study design method was used among secondary and preparatory school student in MehalMeda, Ethiopia. 437 individuals were selected from a total of 9000 by making stratified by grade 9-10 and 11-12 and then further stratified each grade and lastly use simple random sampling to select the participant from each section from each grade. Structured self-administered questionnaire was used to collect data after using pre-test. Epi-Info version 7 was used to enter data and SPSS version 23 software was used to analyze data. Result: A total of 437 high school and preparatory school students were included in the study. Among those 253(57.9%)participants were male. 137(31.4%[27.05%-35.75%]) study participants were alcohol users. Multivariable logistic regression analysis showed that age from 19-22 years had association with alcohol use prevalence by odd ratio 3.01[1.01-44.2] . Conclusion: Relatively high alcohol users were found in high school and preparatory school students. There is a need for collaborated effort to reduce alcohol use prevalence like in school awareness creation in drama form, by forming different club, parent follow student and give advice and woreda education bureau by fencing the school, follow up the school teacher and exchange information about the status of the students.