Food safety as the conditions and measures that are necessary during production, processing, storage, distribution and preparation of food to ensure that it was safe, sound, and wholesome and fit for human consumption. Food safety remains a critical issue nowadays among professionals in the food service sector as well as consumers. The purpose of this study was to assess food quality, food safety knolwedge, hygienic practice and food service system of selected hospitals in Addis Ababa, Ethiopia. In order to achieve the aforementioned objective, mixed method research design or qualitative and quantitative approach was utilized and developed. In this study, part one, a total of 135 respondents for 12 food handlers, 12 cooks, 20 doctors and nurses, 80 for stakeholders, 4 cleaners and 7 interviewed for key informant. Part two, a total of 44 samples, 8 offer raw food, 12 prepared food, 10 wasted food and 14 hand swabs were collected. All samples proposed microbiological analysis were taken directly from hospitals. The result of the study indicated that in both hospitals cafes, food processed and preparation class did not have mechanical ventilation. The two hospitals café food workers were not playing a critical role in ensuring food safety. They did not practice proper personal hygiene, including hand washing practice at the appropriate times and using appropriate methods. Food handlers and workers were lack of awareness about quality and safety of food because both hospitals food administrators were not attentively leading since the cafés were private and they did not give training for café workers. In both hospitals café food handlers contaminated S. aurous bacteria due to poor hygienic practice, lack of personal hygiene and unawareness for the quality and safety of food. Generally, the findings showed 33 strains out of 44 food and swabs samples (75%) were positive with S. aurous. The 33 strains (75%) results range cfu/g103– ≤104 hence unsatisfactory. If cases of food borne illness were suspected, testing for enterotoxin could be considered. The total Staphylococcus colony strains mean 1.515, standard deviation 0.507and variance were 0.258. Therefore, this study showed that cross contaminated food samples was a potential reservoir for S .aurous and might play an important role in transmitting the pathogen to humans. The researcher concluded that the hospital quality team, prevention of diseases committee and food administrators gave less intention for quality and safety of food in both hospitals café. These indicated that in the two hospitals direct and cross contamination on food were developed. Finally, Ministry of education should include food quality and safety in the curriculum materials to gat skilled man power in the area.