The Capacitating One Health in Eastern and Southern Africa (COHESA) project team has embarked on an initiative to assess and enhance the OH landscape in Eastern and Southern Africa (ESA). To achieve the institutionalization and operationalization of OH, the project team has developed a multifaceted evaluation tool to assess the status of OH across research and innovation, governance, education, and implementation. The major findings of this assessment reveal a complex landscape of challenges and opportunities in Ethiopia. Within research and innovation, Ethiopia faces gaps in institutionalization and awareness of OH approaches and principles. In the field of education, participants emphasize the absence of formal OH education aligned with the education system in Ethiopia, emphasizing the need for robust action to align OH approaches and principles into the existing curriculum. Additionally, the governance structure for OH is not fully institutionalized, necessitating policy attention and resource allocation. Implementation of OH efforts also encounters challenges due to the lack of formal institutionalization and dedicated budgets. The Ethiopian COHESA team has developed a comprehensive plan to address these major thematic findings through advocacy, documentation of evidence, capacity building, and the championing of OH at all levels (regional and national). This case underscores the importance of government ownership and collaboration among stakeholders to bridge gaps and establish a solid foundation for OH in Ethiopia. This work also sheds light on Ethiopia’s journey toward institutionalizing and implementing OH practices and serves as a valuable resource for other countries seeking to embark on similar initiatives.