This study assessed the prevalence and associated factors of visual impairment among adults in Nekemte town, Western Ethiopia. A community-based cross-sectional study was conducted from May to June 2022 among 939 adults selected using multi-stage sampling. Data were collected through interviewer-administered questionnaires and ocular examinations, and analyzed using SPSS version 25. The prevalence of visual impairment was 9.7% (95% CI: 7.9–11.7). Multi-variable logistic regression analysis showed that age ⩾ 36 years (AOR = 3.91, 95% CI: 1.62–9.38), family history of eye problems (AOR = 5.45, 95% CI: 2.49–11.92), monthly household income < 3,000 Ethiopian birr (AOR = 5.71, 95% CI: 1.90–17.17), hypertension (AOR = 5.69, 95% CI: 2.75–11.78), and diabetes (AOR = 6.40, 95% CI: 2.68–15.29) were significantly associated with visual impairment. These findings indicate that socioeconomic and systemic health factors contribute substantially to adult visual impairment in this population.