Background: In Ethiopia, there are no studies on age-appropriate vaccinations that children received at the recommended specific ages. Therefore, we assessed age appropriate vaccination coverage and its associated factors among children 12 to 23 months of age in Menz Lalo district, northeast Ethiopia. Methods: A community based cross sectional study was conducted in Menz Lalo district from March to April, 2018 among 417 mothers/caregivers with children 12 to 23 months of age using simple random sampling technique. Data were collected using pretested structured Amharic questionnaire. Age appropriate vaccination coverage was measured using World Health Organization vaccination schedule recommendation. Information about children vaccination status was collected from children vaccination cards. Data was entered into Epi-Info7 software and exported to SPSS-20 for analysis. Logistic regression analysis was carried out to identify factors associated with age inappropriate vaccinations. A p-value of < 0.05 was considered to sate statistically significant association. Results: Age appropriate vaccination coverage were 39.1% (95% CI: 34.1-43.6) for Pentavalent 1, 36.3% (95% CI: 30.5-40) for Pentavalent 2, 30.3% (95% CI: 23.5-32.4) for Pentavalent 3 and 26.4% (95% CI: 18-29.4) for measles vaccine doses. Age inappropriate Pentavalent 1-3 vaccinations was associated with being male child (AOR: 0.47, 95% CI: 0.29-0.74), absence of telephone (AOR: 2.2, 95% CI: 1.4-3.6), absence of usual caretaker (AOR: 2.6, 95% CI: 1.3-5.2), unplanned pregnancy (AOR: 1.9, 95% CI: 1.1-3.5), missing antenatal conference participation (AOR: 2.7, 95% CI: 1.3-5.7), first birth order (AOR: 0.34, 95% CI: 0.17-0.68) and insufficient knowledge (AOR: 2.7, 95% CI: 1.6-4.4). Conclusion: The proportion of age appropriate vaccinations coverage was low in the study area. Modifiable factors were associated with age inappropriate vaccinations. Vaccination interventions should consider identified modifiable factors to improve age appropriate vaccinations coverage.