Worldwide, the human immune deficiency virus is the leading cause of death for women of childbearing age. Around two-thirds of all pregnant women living with the human immune deficiency virus experience an unintended pregnancy. The correct and consistent use of dual contraceptive methods is important to prevent unintended pregnancy and transmission of sexually transmitted infections. However, little is known about the utilization of dual contraceptive methods among HIV-infected women. Thus, this study aimed to assess dual contraceptive utilization and associated factors among HIV-positive women attending antiretroviral therapy (ART) in Finote Selam Hospital, Northwest Ethiopia. Facility-based cross-sectional study design was conducted from September 1 to October 30, 2019, in Finote Selam Hospital among HIV-positive women. A systematic random sampling technique was used to select study participants and the data were gathered by an interviewer-administered structured pretested questionnaire. Factors associated with dual contraceptive use were identified through binary logistic regression. Finally, a p-value < 0.05 was taken as a cutoff point to declare a significant association, and the direction and strength of the association were determined by the adjusted odds ratio. The study showed that 21.8% of HIV-positive women attending ART care in Finote Selam Hospital utilize dual contraceptive methods. Dual contraceptive utilization was significantly associated with having a child (AOR: 3.29; CI 1.45, 7.47), having family support to use dual contraceptives (AOR: 3.02; CI 1.39, 6.54), having multiple sexual partners (AOR: 0.11; CI 0.05, 0.22), and urban residence (AOR: 3.64; 1.82, 7.3). The study revealed that low utilization of dual contraceptive methods. This will continue major public health problems in the study area unless future interventions conducted.