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Abstract Introduction Due to disparities in data gathering and dissemination between nations, it is challenging to provide exact statistics. However, the global scope of reproductive health problems within schools is substantial, with numerous problems influencing the development and well-being of young people. Objective This study aimed to assess the utilization of youth-friendly reproductive health services (YFRHS) by secondary school students in Yeka Sub-City, Addis Ababa, Ethiopia. Method To examine the YFRHS among secondary school students in Yeka Sub-City, Addis Ababa, an institution-based cross-sectional survey was conducted between June and July 2024. A total of 415 students from 15 secondary schools who were chosen randomly participated in this study. A standard, well-structured, self-administered questionnaire was used to collect the data. After cleaning, coding, and importing into EpiData version 4.6.0.2, data were exported to SPSS Windows version 27. Factors related to YFRHS use were identified using binary logistic regression analysis. In multivariable logistic regression, every factor in the bivariate analyses, with a p-value less than 0.25 in the bivariate analyses was included. The strength of relationship was evaluated using the adjusted odds ratio and a 95% CI, with a P value ≤ 0.05 was taken into consideration to announce the statistical significance. Results Youth-friendly reproductive health services (YFRHS) utilization in this study was 18.8% (95% CI: 0.154, 0.227). This study found that having a sexual partner Adjusted Odd Ratio (AOR) (AOR: 3.8 (1.7, 8.4)), having a conversation with parents (AOR: 2.2 (1.2, 4.02)), having YFRHS facilities nearby (AOR: 5.1 (2.5, 10.3)), and believing that seeking behavior improves youth health (AOR: 4.6 (1.5, 14.04)) were all significantly associated with reproductive health utilization. Conclusion Among school-aged youth, one in five used youth-friendly reproductive health services. Reproductive health use was significantly associated with having a sexual partner, having a favorable perspective on whether seeking behavior benefits youth health, having discussions with parents, and having YFRHS facilities in the living area.