The study set out to assess the quality of Early Childhood Care and Education (ECCE) in DireDawa, Harar and Jigjiga cities of Ethiopia. The notion of quality in education can be explored with reference to conceptual frameworks that describe education. In this study, an Input-Process-Output framework was used to form the basis for defining the quality of ECCE. Employing a mixed method research design, 15 preschool centers (seven government-run and eight of them non-governmental) were selected for the study. Fifteen preschool teachers, six grade one homeroom teachers, and thirty children attending preschool were participants of the study. A semi-structured interview, an observation checklist, and a questionnaire were used to collect data. The result of the study indicated the presence of problems that were common across almost all of the preschool centers. The problems included inadequate indoor and outdoor play materials and playgrounds, lack of ECCE curriculum and syllabus, poor planning and management practices, large number of student per class, and shortage of trained teachers. None of the observed preschools were found to be friendly for children with disabilities. Five ECCE quality indicators were measured: Health, Nutrition, Personal care, and Routine, Protective Care and safety, Organization and Management, Children�s Learning Opportunities, Assessment and reporting, and Managing Quality System. The composite mean value of these quality indicators indicated that the practice was intermediate. The lowest mean score was found in government pre-school centers. Moreover, significance difference was observed between government and non-government pre-school centers in their health, nutrition, personal care and routine practices at t (6.0)= - 3.55, P< 0.05, and organization and management practices t (7.69) = -3.59, P< 0.05. Furthermore, the testament of grade one teachers indicated that those who had preschool experiences were better in cognition, language, and academic achievement than those who had not. On the basis of the findings, the study recommended the government to institute a quality control monitoring system and practice to improve quality of education at ECCE centers.