Background; Intestinal obstruction (IO) is one of the most common acute abdominal disorders that often require emergency surgical management in the hospital setting. However, the surgical management sometimes ends with unfavourable outcomes characterized by fatal and nonfatal postoperative complications. Objective; to assess the proportion and associated factors of intestinal obstruction and its management outcome at TGSH Bahir Dar Ethiopia 2021 Methods; an institution-based cross-sectional study was conducted among patients who were surgically treated for IO during the last 1 year at the TGSH. Patient participants were selected using a systematic random sampling technique. A structured research tool was used to collect all the necessary data from the patients’ medical records. Data was analysed by using SPSS version 21 Frequencies with percentages was used to describe the surgical management outcome of IO. Binary logistic regression model was used to explore the determinant factors associated with the surgical management outcome of IO. Factors at P value< 0.05 were declared statically significant. Result: During the 1 year study period, there were 2023 total surgical admissions in TGSH surgical ward. Being male sex is a risk for intestinal obstruction (p=0.003) and adjusted odds ratio (AOR) of 3.24 and 95% CI. Rural residence had also significantly associated with intestinal obstruction with AOR=12.53 and 95% CI. Duration of illness before operation (in days) had also significantly associated with intestinal obstruction. Conclusion: Intestinal obstruction was the second common cause of acute abdomen in TGSH. In conclusion, small bowel obstruction was more prevalent than large bowel obstruction in this study. Adhesion/ band and sigmoid volvulus were the leading causes of small and large bowel obstruction, respectively. IO was more common in rural dwellers and male sex. Most patients were relatively old, in the 5th and6th decades of life. Kay words: Intestinal obstruction, Prevalence, Causes, Management, Hospital