Background: Intrauterine device is a modern contraceptive method used in family planning process, it prevents conception (pregnancy) and it has duration of 12years. There some women of reproductive age who don’t use this method, which necessitates our concern to why they don’t use it. The aim of this study is to explore the knowledge and attitude toward utilization of IUCD as family planning method among women attending at Makambako RCH. Methods: A descriptive cross-sectional quantitative study was used to assess knowledge and attitude concerning use of intrauterine contraceptive device among 384 women of reproductive age. Random sampling was conducted in which every individual had an equal chance to be selected and structured self-administered questionnaire were used to collect data. Data was entered to Microsoft excel and then exported to SPSS version 20.0 for further analysis. Results: Findings of the study about 333 (86.7%) respondents had knowledge on IUD while 51 (13.3%) they lack knowledge on IUD and they agreed it helps to prevent unwanted pregnancies and they heard it from social media like radio and television, health care providers, friends and school. About 46 (12%) of the respondents had positive attitude and used IUD method of family planning, and they got influence of using IUD from health care providers, 82 (21.4%) got influence of using IUD from their partners and 27 (7.0%) influenced to use IUD due to the side effects of other family planning methods like Depo Provera and pills. 25 (5.7%) were not influenced by anyone to use IUD as family planning method. While 338 (88.0%) participants had negative attitude on IUD method and had never used IUD as family planning method. Conclusion: The findings show that IUD usage was found to be poor and majority of them they didn’t prefer it, despite of having less complications.