Background: Bowel obstruction is a global public health problem consuming much in terms of surgical services which varies between regions of the world. It is a common surgical emergency and a significant health problem in Ethiopia. Several factors contribute to poor management outcomes in the case of Bowel obstruction. Objective: The aim of this study was to assess the operative treatment out comes of bowel obstruction and associated factors in Debre Tabor comprehensive specialized hospital north west Ethiopia2022. Methods: Institution based cross sectional study with patients’ chart review was conducted among 400 patients operatively managed for bowel obstruction, from April 08 to June 30, 2022.The charts of patients were selected using a systematic random sampling technique. Checklist was used to collect the data from the patients’ medical records. The data were analyzed using SPSS version 25. Frequencies with percentages were used to present the data. Bivariable and multivariable logistic regression analysis was used to identify factors associated with dependent variable. Factors at P<0.05 were declared statically significant. Result: 79% patients have Good surgical management outcomes of Bowel obstruction.History of chronic illness(AOR :0.184,95 CI(0.076-0.445,)Abdominal tenderness(AOR: 0.207, 95 CI(0.086-0.497)), preoperative diagnosis(AOR:2.13, 95CI(1.33-3.41)), postoperative vital sign(AOR:0.108,95 CI (0.28-0.413)),intraoperative blood transfusion(AOR: 0.344, 95 CI (0.134-0.883)),and intraoperative procedure(AOR :0.369, 95 CI(0.177-0.771)) were significantly associated. Conclusion: In this study, good surgical management outcomes of bowel obstruction are lower related to study done University of Gondar comprehensive specialized Hospital. Thus, designing a strategy addressing the significantly associated factors could help to decrease poor surgical management outcome.