**Background:** Rapid urbanisation in Ethiopia (2021–2026) has coincided with an increased burden of non-communicable diseases (NCDs). Urban green space accessibility, a potential modifier of NCD risk, is concurrently changing, but context-specific evidence from Ethiopia is limited.

**Purpose and objectives:** This study explored the perceived influence of green space accessibility on NCD behavioural risk factors—specifically physical inactivity and stress—among adults in rapidly expanding Ethiopian cities. It also sought to identify contextual barriers to using these spaces.

**Methodology:** A qualitative, exploratory study was conducted in 2023. Data were collected via 12 focus group discussions and 25 in-depth interviews with purposively sampled residents from three major cities. Data were analysed using reflexive thematic analysis.

**Findings/Key insights:** A central theme was the ‘disconnect between proximity and usability’. Although some green areas were physically present, perceptions of poor safety (particularly for women and children), inadequate maintenance, and cultural norms that discourage leisure-time physical activity severely constrained their use for health promotion. Participants directly associated easy access to safe, appealing green space with lower stress levels and greater motivation for recreational walking.

**Conclusion:** In the Ethiopian urban context, mere physical proximity to green infrastructure is inadequate for realising its potential health benefits. Social, safety, and cultural factors critically mediate its use for mitigating NCD risks.

**Recommendations:** Urban planning and public health policies should integrate community-centred design, ensure regular maintenance, and proactively address safety concerns to improve green space usability. Public awareness campaigns should promote the use of these spaces for wellness, adapting messages to local cultural contexts.

**Key words:** Urban health, green infrastructure, non-communicable diseases, qualitative research, Ethiopia, health equity.

**Contribution statement:** This study provides context-specific evidence from Ethiopia on the socio-cultural barriers affecting green space utilisation for NCD prevention, offering insights for local public health and urban planning strategies.