Scaling-up the innovation across a large geographical area as part of the Community Based Newborn Care package produced challenges, yet there have also been positive and enabling factors in Ethiopia. IDEAS wanted to understand what helps and what hinders the scale-up of community-based maternal and newborn health (MNH) innovations, both within and beyond implementation partner areas, and how scale-up can be catalysed. IDEAS and its partners carried out a case study of an MNH innovation in Ethiopia with its roots in the Community Based Interventions for Newborns in Ethiopia (COMBINE) project which enables Health Extension Workers (HEWs) to administer antibiotics to manage neonatal sepsis at community level. This was evaluated through a randomised controlled trial. The innovation was facilitated by Save the Children USA, through Saving Newborn Lives (SNL), and was initially implemented by HEWs and the Health Development Army in 19 districts (‘woredas’) of Ethiopia. From late 2013, the innovation was being scaled-up to 92 woredas as one of nine components of Phase One of the Ethiopian Government’s Community Based Newborn Care (CBNC) package. This summary presents evidence from the study and identifies both enablers and barriers to scale up and key actions needed to catalyse scale up.