Background: Cancer ranks as a leading cause of death and an important barrier to increasing life expectancy in every country of the world. According to estimates from the World Health Organization (WHO) in 2019, cancer was the first or second leading cause of death before the age of 70 years in 112 of 183 countries and ranked third or fourth in a further 23 countries. The outcome of malignancy after treatment depends on stage, grade, and age, type of malignancy, treatment modality and co morbid illness. Early stage, low grade tumor, had better outcome. Some of the most common cancer types, such as breast cancer, cervical cancer, oral cancer, and colorectal cancer, have high cure rates when detected early and treated according to best practices. Some cancer types, such as testicular seminoma and different types of leukemia and lymphoma in children also have high cure rates if appropriate treatment is provided, even when cancerous cells are present in other areas of the body. Objective: To assess the outcomes and determinant factors of malignancy after surgery in TibebeGhion Specialized Hospital Bahir Dar, Ethiopia Methods: A retrospective chart review for patients operated at surgery department. And all the necessary data was collected from operated patients’ cards using the pre-developed data collection format. Total number of patients who had cancer operated during 2yrs were 630.from this sample size is calculated using P-value 0.5%.then the sample size were adjusted the final sample size was 239.After data collection the data was entered into Epi data then exported to SPSS 25 version and analyzed through it Result: death rate in patients with inadequate lymph node dissection was 66.7%, those with co morbid illness were 25.2%,those with palliative procedure was 34.7% ,those with complication was 28.7%,those with positive surgical margin was 43.5% and those with serum albumin <3.5mg/dl 26.7%. Conclusion: The study showed that patient with co morbid illness, in adequate lymph node dissection, those having complications, operated for palliative purpose had significant death rate.