Dissertation (MSc Midwifery)Background: Despite a national target of 80% cervical cancer screening for all women from 30 to 50 years old by 2020, Mara Region managed to screen only 4% of all eligible women. In spite of several efforts to scale up cervical cancer screening the uptake is still low. Basing on these reasons, client based reasons for low uptakes on cervical cancer screening are to be addressed. . Methods: This study employed across-sectional design where by 296 women of reproductive age 18-49 years from three district councils in Mara region were randomly selected. Data on factors related with uptake of cervical cancer screening were generated through interviewer-administered questionnaire. Health Belief Model and self-determination theory were used to guide the study. Descriptive analysis was employed to establish the status of uptake of cervical cancer screening. Likewise, bivariate and multivariate logistic regressions were used to establish predictors of cervical cancer screening uptake. Results This study found that, 68.2 % of all respondents that makes majority of them were not screened for cervical cancer. It was also found that half of them which are 56.8 were aware of cervical cancer screening.. Majority of respondent had adequate knowledge of risk factors of cervical cancer (59%). Furthermore, 64.5% of all respondents perceived themselves as prone to cervical cancer yet majority. The study further observed that, Sixty seven percent (66.9%) understood the benefits of screening while (56.4%) perceived cervical cancer as a threat. Half of respondents (50%) reported barriers to screening. Regarding the variables of SDT, most of respondents were having high perceptions in which (60.1%) perceived competence, autonomy (61.1%) and relatedness (57.1%). After adjusting for confounders, awareness [Not aware (AOR=0.518 at 95%CI=0.306-0.877, p=0.014)], marital status [married (AOR=0.505 at 95%CI=0.281-0.907, p=0.022)] and occupation [employed (AOR=0.162 at 95%CI=0.039-0.676, p=0.013)] were significantly associated with cervical cancer screening uptake. Conclusion Cervical cancer screening uptake in Mara region was found to be very low. Factors that cause this low coverage include: awareness, level of knowledge, and women’s perception on cervical cancer screening. It was further found that marital status, women’s occupation and awareness was significantly associated with the low uptake of cervical cancer screening in Mara region.