Khat is found in the evergreen tree or large shrub consists of whole rash leaves and buds of a plant known as Catha edulis. It is an indigenous tree to Ethiopia, Kenya, and more than 20 different compounds are fund in khat. Khat chewing practice renders certain influence on physical and psychological well being of the community and it can cause more serious adverse psychiatric, cariodiovascular, dental and gastrointestinal effect. The recent sharp increase khat consumption may not only affect the health of individuals but could also have serious socio ? economic consequences. This study was conducted to assess prevalence of khat chewing practice; it perceived health effect among chiro town. Community based cross- section study was determined by using single population proportion formula and 20 households were selected by systematic sampling method and in the selected by lottery among members of household aged 15 years old and above. Data were collected by manse of questioner analysis was carried out using SPSS version 20. For the qualitative part 264 individuals were purposely selected and sample size for this method was determined through participant. Results: The khat chewing is most commonly practiced among male gender (72%) compared to female (28%). Muslim were more likely to chew khat (38%) compared to orthodox Christians and other. Respondent who had family member without a chewer. Among the entire respondent 94.7% agree on chat chewing practice had perceived health effect and 5.3% of the respondent Dis agree. Conclusions: The prevalence of khat chewing practice was 62% with high proportion of the khat chew found in the urban setting. Sex, religion, residence, family chewing habit and perceived health effect were significantly associated factors with khat chewing practice. In this study 94.7% of the respondents perceived that khat chewing practice had harmful effect on health and the perceived health effect reported were slapping disorder, hallucination, hypertension, loss of appetite, depression and gastrointestinal adverse effect like gastritis.