Background: Acute abdomen is an acute onset of abdominal disease entities that require immediate surgical intervention in most of the cases.The causes of non-traumatic surgical acute abdomen and their relative incidence vary in different populations.Most of patients experienced post-operative complications were those who came late, old age, delay diagnosis and related with developing peritonitis. There are only few studies on non-traumatic surgical acute abdomen in Ethiopia.Objective: To assess the management out come and associated factors of surgically treated non-traumatic acute abdomen. In Deber Markos Comprehensive Specialized Hospital, North West Ethiopia.Methods: A hospital based cross-sectional study design was conducted on surgically treated non-traumatic acute abdomen from September 1/2019G.C-August 30/2020 G.C and the data of sampled patient record was collected from medical records. Then it was coded, entered, cleaned and analysed using SPSS version 25. Data was analyzed and presented by using frequency distributions and logistic regression. On binary logistic regression analysis, a p-value < 0.25 was used as a reference to be a candidate for multivariate logistic regression analysis. P Value <0.05was considered as statically significant. Results: In this study 275participants were included and finally analyzed. From these ,42(15.3%) patients have unfavorable outcomes. The most common postoperative complication occurred was surgical site infection (6.9%), sepsis (4.7%), leak (3.6%)and pneumonia(3.6%) among those 13(4.7%) postoperative deaths were also documented asunfavorable surgical management outcomes. Of the determinant factors analyzed in this study, only four factors, durationof illness before surgery, length of hospital stay after surgery, comorbidity, and hypotension were significantly associated withthe management outcome.Conclusions: In this study, the majority of patients had favorable surgical management outcomes, and the proportion of patients with unfavorable outcomes was however considerable. Thus, designing a strategy addressing the significantly associated determining factors could be helpful to further increase the likelihood of favorable surgical management outcomes of non-traumatic acute abdomen. Keywords: Non-traumatic surgical acute abdomen, complications, outcome