Background. A significant number of adolescents as well as young men and women aged 10 to 24 years die each year in the world due to avoidable sexual and reproductive health problems such as unwanted pregnancy, unsafe abortion, and sexually transmitted infections, including HIV/AIDS. This is attributed to low access to and/or uptake of sexual and reproductive health services. Objective. To assess parent-adolescent communication on sexual and reproductive health issues and associated factors among secondary and preparatory school students in Dabat town, northwest Ethiopia, 2018. Methods. An institution-based cross-sectional study was conducted from April 1 to 10, 2018, using multistage sampling technique. Data were collected from 550 participants using structured, pretested, and self-administered questionnaire; entered into Epi Info version 7; and analyzed using SPSS version 20. Both bivariate and multivariable logistic regression analyses were employed, and variables with less than 0.05 P value in the multivariable regression were considered as statistically significant. Adjusted odds ratio with 95% CI was used to determine the strengths and directions of associations. Result. This study revealed that 48.5% of the participants discussed sexual and reproductive health issues with parents. Male sex (AOR = 1.6; 95% CI: 1.1–2.25), family income greater than ETB 1,000 (AOR = 1.6; 95% CI: 1.02–2.57), good knowledge of sexual and reproductive health (AOR = 1.5; 95% CI: 1.03–2.09), and favorable attitude to sexual and reproductive health issues (AOR = 1.9; 95% CI: 1.29–2.67) were factors significantly associated with parent-adolescent communication on the issues. Conclusion. This study showed that the proportion of parent-adolescent communication on sexual and reproductive health issues was low. Male sex, family income greater than ETB 1,000, and good knowledge and favorable attitude of adolescents had significant association with the communication.