Introduction: - Discharge against medical advice also known as “self-discharge” or “discharge at own risk” is discharge of a patient from a hospital without the agreement of the treating team. It has a negative impact on the wellbeing of the patient. DAMA has been documented in numerous healthcare settings and accounts for 0.32–18% of the discharges of pediatrics patients worldwide. The child has the right to enjoy a good health: psychological, physical, and environmental health. Objectives: -This study was aimed to determine the magnitude and determinants of discharge against medical advice among pediatrics in Tibebe Ghion Specialized Hospital from August 30, 2021, September 30, 2022 G.C Methods: - Institution based cross-sectional Study was conducted among 356 pediatrics age group patients in Tibebe Ghion Specialized Hospital from August 30, 2021, September 30, 2022 G.C The study participants were selected by simple random sampling technique. The data were collected by patient chart review and interviewer-administered questionnaire. The data were entered using EPI data version 4.6 statistical software and exported to SPSS version 25 for analysis. Binary Logistics regression models (Bivariate and multivariable analysis) were also carried out to see the association of each independent variable on the dependent variable. Results: Out of the 356 admitted patients during the study period, 35 were discharged against medical advice giving a DAMA rate of 9.8%. Those patients who had ≥7 days or one week of admission time (adjusted odds ratio (AOR) = 2.5; 95% CI: (1.04-6.21); P = 0.039). Caregivers who completed primary school (AOR= 0.24; 95%CI (0.06-0.95) p=0.0043). Patients whose patient’s terminal condition or status were same (AOR) =6.7; 95% CI: (1.94-24); P=0.003) were factors associated with medical discharge. Conclusion and recommendations: In this study the magnitude of DAMA was relatively high. Duration of Admission, educational status of the care giver, and patient’s terminal condition showed statistically significant association with discharge against medical advice. Hence, it is recommended that awareness should be offered to those patient’s caregivers whenever it is appropriate. It is also important to shorten the length of hospital stay to the possible lowest duration. It is important for the government at all levels that Community Based Health Insurance (CBHI) being implemented. Key words: Against, Discharge, Medical, Advice, Tibebe Ghion, Ethiopia