Summary Objective To evaluate the change in household latrine coverage and investigated predictors of latrine uptake after 3 years of implementation of trachoma control interventions in Dera, Ebinat, Estie, Enebsie Sarmedir and Huleteju Enese districts of Amhara, Ethiopia. Methods Before and after study, baseline surveys were conducted prior to programme implementation and an evaluation after 3 years of interventions. Multi-stage cluster random sampling was used in both surveys. Results A total of 1096 and 1117 households were sampled and assessed for the presence of household latrines at baseline and evaluation, respectively. The proportion of households with a pit latrine increased by 32.3% overall (95% confidence interval [CI]: 27.9–38.0), ranging from 8.0% (95% CI: 5.1–10.8) in Ebinat to 58.9% (95% CI: 51.9–66.8) in Enebsie Sarmedir. Logistic regression analysis of associations between household latrine ownership and potential factors showed that increasing household size (ORper additional person = 1.2[95% CI: 1.1–1.3]), higher socio-economic status (tin roof) (OR = 1.8[95% CI: 1.2–2.9]) and participation in health education (OR = 1.6[95% CI: 1.1–2.5]) were independent predictors of latrine ownership. Conclusion Our study documented heterogeneous increase in household latrine coverage after 3 years of latrine promotion; two of five districts had achieved millennium development goal 7.9 and halved the proportion of households without latrine access. We attribute the striking increase in household latrines to increased political commitment of the local government and intensive community mobilisation under the trachoma control programme in Amhara region.