Introduction: Diabetic ketoacidosis is an acute life-threatening complication of diabetes mellitus. With appropriate treatments, diabetic ketoacidosis patients are expected to make a full recovery within 24 hours. Previous studies did not address variables such as duration of diabetic ketoacidosis symptoms, and blood glucose level. In addition, the recovery time and its predictors of diabetic ketoacidosis in adult patients are not well known in Ethiopia. Objective: To assess time to recovery from diabetic ketoacidosis and its predictors among adult diabetic ketoacidosis patients in Debre Markos referral hospital, North West Ethiopia, 2021 Methods: A retrospective cohort study was employed among 452 records of adult diabetic ketoacidosis patients who were admitted starting from January 1, 2016 to January 1, 2021 using their medical registration number. Data were entered into Epi-data version 4.6 and analyzed using Stata version 14. A Kaplan Meier survival curve was used to estimate diabetic ketoacidosis-free survival time. In addition, a generalized log-rank test was utilized to compare diabetic ketoacidosis-free survival time between different categorical explanatory variables. Cox proportional hazards model was used to identify predictors of time to diabetic ketoacidosis recovery time. Variables with a P-value < 0.25 in the bivariable analysis were entered into a multivariable Cox proportional hazards model to identify predictors of recovery time at p≤ 0.05. Result: The median time to recovery from diabetic ketoacidosis for all observations was 24 hrs. Severity of diabetic ketoacidosis (AHR=0.24, 95%CI=0.16-0.35), duration of diabetic ketoacidosis (AHR=0.46, 95%CI 0.33-0.64), diabetes duration (AHR=1.74, 95%CI 1.35-2.25), and random blood sugar level (AHR=0.64, 95%CI= (0.51-0.79) were significant predictors of recovery time. Conclusion and recommendation: The median time to recovery from diabetic ketoacidosis was relatively prolonged. The hospital shall give special attention to patients with the identified predictors. Further study using a prospective design by including admission pH and admission serum potassium level is advised. Keywords:-Diabetic ketoacidosis, recovery time, Debre Markose, Ethiopia