Background: Pneumonia is an acute infection of the pulmonary parenchyma by different pathogen mainly bacteria and virus. It causes of significant morbidity and mortality worldwide. Objectives: To determine inpatient treatment outcomes and associated factors to poor outcome among adults admitted with pneumonia from Jan. 1st, 2020 to Jan.31, 2022 at TGSH in Bahir Dar, Ethiopia Methods: Hospital based cross sectional study was conducted. Systematic random sampling was conducted to select study subjects records. Collected data was entered into SPSS version 26 for analysis. To determine the proportion of demographic and other clinical data, descriptive statistics were used. Bi-variable analysis was carried out between the dependent and independent variables with significance level of p-value<0.25.Binary logistic regression was performed with all independent variable which had significant association on bi-Variable analysis to determine how these variables affects poor outcomes of pneumonia with control of other variables constant Results: A total of 368 study participants’ medical records were reviewed, of which 20 (94.6%) of the data were complete. The mortality rate for pneumonia patients who were admitted was 14.4%. Intubated patients (AOR=28.5, 95% CI: 9.261-87.705), age 65 years and above (AOR=17.242, 95% CI: 4.887-60.836), deranged initial renal function test (AOR=8.941: 95% CI: 3.006-26.590), were significantly associated with the outcome. Conclusion: The mortality rate of patients with pneumonia who were admitted to the hospital with pneumonia in this study was 14.4%. There is a significant association between pneumonia mortality and age, an initial abnormal renal function test, and the need for intubation. Keywords: Pneumonia, Pulmonary parenchyma, Inpatient, Outcome, Morbidity, Mortality