Safe sanitation service is vital to a healthy life and promoting well-being. However, information on the proportion of households' access to safely managed sanitation services and its determinants in urban resource-limited settings is particularly scarce in Ethiopia. This study aimed to determine households' access to a safely managed sanitation service and its associated factors in Jimma, Ethiopia. A cross-sectional study design was conducted on 782 households selected randomly. Household heads were interviewed using a structured questionnaire and facility conditions were assessed using an observation checklist. The proportion of households with access to sanitation services was presented in frequency and percentage. A binary logistic regression analysis was employed to determine the association between the explanatory and dependent variables. The study found that a significant proportion of households (87%) use unsafe sanitation services. The presence of a school-attending family member, a smaller family size, heads of households engaged in private work, wives engaged in employed work, a higher monthly income, and toilet age are all associated with access to safely managed sanitation. To ensure safe sanitation access in the setting, sanitation interventions should take into account household differences; prioritize sustainable sanitation technology options in newly built toilets; improve households' economic status; and expand job opportunities and education for mothers, which demands long-term policy interventions.