Introduction: Trachomatous trichiasis(TT) is eye disease caused by repeated infection of bacteria called Chlamydia trachomatis. It affects the health and quality of life of the family and a community at large. However, there were a few evidences on determinants of trachomatous trichiasis among women. Therefore, this study was important to fill this gap, help to design and improve the future interventions and control strategy. Objective: To identify determinants of trachomatous trichiasis among women, in Bora district, East Shoa zone, Oromia, Ethiopia, 2023. Method: Community based matched case-control study design was employed to conduct the study in Bora district from February 27 to April 12, 2023. The study populations included all women age 15 years and above living in the selected kebeles. Each case matched to four controls by age and residing kebele. Sample sizes were 380 (76 cases and 304 controls). Trichiasis cases and controls were identified through community based screening during TT screening campaign consecutively till the desired sample size reached. Data were collected and entered into EPI-info version 7.2 then exported to STATA version 17 for analysis. Bi-variable and multi-variable binary conditional logistic regression analyses were employed. Finally, variables with Adjusted Odds Ratio at 95% CI, P-value <0.05 were considered significance variable. Result: A total of 380 (76 cases and 304 controls) subjects were included in this study. Variables such as educational status those who could not read and write (AOR = 5.98; 95% CI: 1.82, 19.65), irregular face washing (AOR = 5.03; 95% CI: 1.97, 12.88) and non-availability of latrine (AOR = 5.80; 95% CI: 2.49, 13.52) were identified determinants of TT among women. Conclusion: Improved educational status, regular face washing and latrine construction of the community may decrease the likelihood that people were at risk of developing TT.