The study aims to explore the practice of continuous assessment (CA) and associated challenges of implementation in higher education institutions located in Amhara National Regional State, Ethiopia. Drawing on assessment for learning and institutional theory, the qualitative multi-case design includes informants from three public universities. Twelve key participants, such as quality assurance directors, academic affairs officers, and experienced teachers, were selected for semi-structured, in-depth interviews using purposive sampling. Thematic analysis was used to analyze data from the interviews. The study revealed improper use of continuous assessment in public universities in the Amhara region. This misuse was shown by neglecting assessment for learning, inadequate feedback, discrepancies between continuous assessment and final exam grades, limited assessment methods, low student involvement, and lack of standardization among universities. These issues are linked to challenges related to teachers, students, and structures. The study highlights the importance of teacher training and consistent standards for the successful implementation of continuous assessment in Ethiopian higher education institutions.