Background: Non-traumatic surgical acute abdomen is an acute onset of abdominal diseases and one of the most commonly encountered surgical emergencies that require urgent surgical intervention. However, there was not much study done about study the outcomes of non-traumatic acute abdomen and associated factors in our hospital. Objectives: To assess the outcomes of non- traumatic acute abdomen and associated factors in adult patients at TGSH, Bahir Dar, Ethiopia. Method: A retrospective Hospital based cross sectional study was done and random sampling technique was used ,303 records were examined , pre-tested data extraction checklist was used to collect the data and entered by kobo tool box then exported and analyzed using SPSS version 26 , binary logistic regression model used ,and finally Adjusted Odds Ratio with 95% CI and p value less than 0.005 was considered as statistically significant for the assessment of Outcomes of non-traumatic acute abdomen and associated factors in adult patients at Tibe be Ghion Specialized Hospital, department of surgery, Bahir Dar, from October 28,2022-November 8,2022. Results: The prevalence of non-traumatic acute abdomen was found to be 90%. Those patients with guarding (AOR=2.976,95% CI = (1.0465,8.467), post operative complication (AOR=0.165 ,95% CI= (0.077,0.353), and temperature >=37.5 (AOR=5.876,95% CI= (1.775,19.450) were significantly associated with outcome of non-traumatic acute abdomen. Conclusion: Appendicitis was the most common cause of non-traumatic acute Tibebe Ghion Specialized Hospital followed by intestinal obstruction, and peritonitis. In this study we have noticed 88.1% of the patients had favorable outcome which is high and the overall mortality rate was also low (1%) which is acceptable compared to other studies. Participants who had no fever, guarding, and post operative complication had favorable outcome. Pre and post operative management are important to decrease post operative management. Key words: Acute abdomen, Non-traumatic, Outcome, Tibebe Ghion Specialized Hospital TABLE OF CONTENTS