Background: Epidural hematoma (EDH) is a major traumatic brain injury and a potentially life-threatening condition. Epidural hematoma is one of the most common causes of mortality and morbidity among head injury, but little is known about the problem in Northwest Ethiopia. Intracranial hematoma is the collection of blood in the various intracranial spaces. Objective: To assess the surgical management outcome and associated factors of epidural hematoma in Felege Hiwot Comprehensive Specialized Hospital (FHCSH) and Tibebe Ghion Teaching Hospital (TGTH), Bahir Dar City, Northwest Ethiopia, 2022. Methods: Institution-based retrospective cross-sectional study among 366 epidural hematoma patients charts from January 2020 January 20, 2022 at TGTH and FHCSH, Northwest Ethiopia. Systematic random sampling technique was used to select patient charts. Data were collected by reviewing patient charts using pre-tested questionnaires. Data were entered into the Epi data version 3.1and exported to SPSS version 23 for further analyses. A binary logistic regression model was fitted to identify the associated factors. Variables with P-value < 0.25 in the bi-variable analysis were a candidate for multivariable analysis and P-value <0.05 in the multivariate analysis were used to declare as statistically significant. The odds ratio (OR) with a 95% confidence interval (CI) was used to measure the strength of association. Results: Over all, death among EDH treatment was 20(5.5%, 95% CI: 3.3-7.7%) outcome was death. The most common presentation of EDH were headache 343(93.7%), LOS 330(90.2%), vomiting 298(81.4%), and 107(10.9%) increased ICP. Of patients with increased ICP 64(59.8%) had decreased mentation followed by 33(33.7%) vomiting and 91(24.9%) had hypertension. The increased ICP (AOR=5.72, 95% CI: 1.55-21.07), >25mm thickness of hematoma (AOR=5.29, 95% CI: 1.43-19.61) and hypotension (AOR=4.30, 95% CI: 1.41-13.08) was significantly associated with the outcomes of EDH treatment. Conclusion: The outcome of EDH treatment was comparable with other studies. The increased ICP, >25mm thickness of hematoma and hypotension was significantly associated with the outcomes of EDH treatment. Health care professionals should closely monitor blood pressure and the size hematoma >25mm. Key words: Epidural hematoma, traumatic brain injury, outcome, trauma, craniotomy