Author summaryFood-producing animals are the major reservoirs for many food-borne pathogens. Milk and meat and their products are important reservoirs for many of the food-borne pathogens. Among food-borne diseases associated with consumption of milk and beef is E. coli O157:H7. On the other hand, the increasing emergence and spread of antibiotic resistant E. coli O157:H7 has become a significant concern globally. Prompt and precise identification of bacterial pathogens in food is critical for tracing bacterial pathogens within the food chain. A total of 384 samples were collected to estimate prevalence and identify associated factors of E. coli and E. coli O157:H7 and to determine antibiotic resistance pattern of E. coli O157:H7 from foods of bovine origin in Dessie and Kombolcha towns. Overall prevalence rates of E. coli and E. coli O157:H7 were 54.7% and 6.5%, respectively. Multidrug resistance was observed among all isolates of E. coli O157:H7. The current study indicated that different foods of bovine origin in the study area were unsafe for human consumption. Hence, preventive measures are required to improve the wholesomeness and safety of foods of bovine origin. E. coli are frequently isolated food-borne pathogens from meat, milk, and their products. Moreover, there has been a significant rise in the antimicrobial resistance patterns of E. coli O157:H7 to commonly used antibiotics. A cross-sectional study was conducted from October 2019 to July 2021 to estimate prevalence and identify associated factors of E. coli and E. coli O157:H7 and to determine antibiotic resistance pattern of E. coli O157:H7 from foods of bovine origin in Dessie and Kombolcha towns. A total of 384 samples were collected. Systematic and simple random sampling techniques were employed for sampling carcasses and milking cows, respectively. E. coli and E. coli O157:H7 were detected according to recommended bacteriological protocols. E. coli O157:H7 strains were evaluated for in vitro antimicrobial susceptibility using agar disk diffusion method. Both descriptive and inferential statistical techniques were applied to analyze the data. Overall prevalence rates of E. coli and E. coli O157:H7 were 54.7% and 6.5%, respectively. Highest prevalence rates of E. coli (79.6%) and E. coli O157:H7 (16.7%) were obtained from carcass swabs and milk tank samples, respectively. Unlike E. coli O157:H7, a statistically significant difference in the E. coli prevalence (P<0.05) was observed among the different sample types. Multidrug resistance was observed among all isolates of E. coli O157:H7. All E. coli O157:H7 isolates (100.0%) were susceptible to Ampicillin, Sulfamethoxazole-trimethoprim, and Norfloxacin. On the contrary, all of the isolates (100%) were resistant to Penicillin G, Vancomycin, and Oxacillin. The current study indicated that different foods of bovine origin in the study area were unsafe for human consumption. Hence, good hygienic production methods should be employed to ensure the safety of foods of bovine origin.