Background: In Ethiopia, close to 120,000 newborns die annually and newborn mortality now constitutes 42% of under-five deaths. The use of health care for newborn illnesses is very limited.Objective: To investigate local perspectives and practices related to newborn care-seeking and the factors affecting them.Methods: Key informant interviews with grandmothers and in-depth interviews with mothers, TBAs and fathers were used to collect data in four communities in Sidama Zone, Southern Nations, Nationalities and Peoples Region and East Shewa Zone and West Arsi Zone in Oromia Region. Analysis consisted of manual thematic coding of the data and synthesis for write-up.Results: Locally recognized signs and types of illness only partially conform to medically recognized danger signs. Households apply home therapies, traditional healers or health facilities to get treatment for sick newborns. Lack of resources, transportation and appropriate treatment are barriers to making use of health facilities.Conclusion: Local conceptions of newborn illnesses, inadequate recognition of danger signs, using traditional treatment, and lack of financial resources, transportation and appropriate treatment constrain or delay resorting to health facilities for newborn illnesses