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The current aim of the Ethiopia‟s Millennium Development Goal declaration is to alleviate poverty through improving the strategy of effective utilization of water supply sources. In order to achieve the goal, a priority area is providing adequate and quality water. The study was conducted in Simada District, Amhara Regional State, Ethiopia, where after considerable expansion of the water supply systems, people still rely on unimproved water sources that may be contaminated with waterborne diseases. The objective of the research was to investigate the reasons behind the use of unprotected sources in both urban and rural settings. Sixteen water points were selected. Three water points (that were functional) were located in urban areas, and the remaining 13 in rural areas ranged from nonoperational to completely functional. Forty four households were interviewed in the urban area and 116 in the rural area, covering water consumption behavior, perception of water source quality, and factors determining use. Water quality was determined at 11 selected water points representing both improved and unimproved sources