Background: Trachoma, one of the neglected tropical diseases, is a major public health problem in developing countries. Ethiopia has the highest prevalence of active trachoma and it is endemic in 604 rural districts with 73,164,159 people being at risk of infection. However, in the study area, the prevalence and distribution of active trachoma for children 1-9 years old were not known. Therefore, this study was intended to describe prevalence and distribution of active trachoma among children 1-9 years old at Leku town Southern Ethiopia. Methods: Community-based cross-sectional study was conducted at Leku town from June 1 to July 15, 2016. Systematic random sampling was used to select study participants. Each selected child 1-9 years old was clinically examined for active trachoma. Data were collected by using pre-tested questionnaire and observation. SPSS version 20 computer software was used to enter data into the computer and data analysis. Results: The overall prevalence of active trachoma among children 1-9 years old found to be 11.0% (Trachomatous inflammation- Follicular 9.8% and Intense 1.2%). Educational status of the household head (X2=12.4, p-value=0.006), economic status of the household (X2=4.55; p-value=0.033), soap use for children’s face washing (X2=5.28 p-value=0.021) and children’s facial cleanness (X2=75.6, p-value=0.000) had significant association with prevalence of active trachoma. Conclusion: In this study, the prevalence of active trachoma is above WHOs’ cutoff point to commence mass antibiotic (azithromycin) distribution combined with measures to encourage facial cleanness and improve sanitation in the affected community. In the meantime, the current study prevalence indicated that trachoma is a public health problem in the study area. While we recommend further studies to be conducted using optimum sample size to compute more accurate population level prevalence and identify risk factors in the study area.