Introduction: Globally Road traffic injuries are the leading cause of death for children and young adults costing most countries 3% of their gross domestic product. Ethiopia has high burden of road traffic accidents compared to other African countries. Amhara region share the highest and majority Road Traffic Accident deaths occur in urban areas, RTA still an under-reported and neglected area to be studied and solutions to be obtained promptly. In Ethiopia, and Amhara region Tibebe Ghion specialized Hospital in particular have no data showing the pattern of the injury among road traffic trauma victims and determinant of management outcome. Previous studies largely addressed the mechanism of road traffic accidents and very limited hospital based studies of road traffic accident-related injuries detecting clinical outcomes and predict why the casualties die beyond the seriousness of the actual injury. Objective: To assess the pattern of injury and factors associated with outcome of RTA among patients visited TGSH in Bahir Dar, Ethiopia. Methods: A cross sectional study was conducted at TGSH in Bahir Dar, Ethiopia. The sample size was 268 cases who sustained RTA and visited TGSH ER in time period from January 1, 2022 to June 31, 2022. Checklist used to retrieve information from the patient medical document. The collected data was cleaned, and entered into Epidata and then exported in to SPSS 25 for analysis and bivariate analysis was computed. Variable who had P value < 0.25 were included in multivariate analysis. Result: Out of 380 Road traffic trauma patients a total of 268 of road traffic accident victims were enrolled in this study. Men comprised of 207(77.2 %) and women 61(22.8 %). The modal age group 75.7% was 19–45 years. Majority had head injury 110(41%) followed by extremity fractures and soft tissue injuries 81(30.2%). Two hundred twenty eight (85.1 %) were discharged improved, 22(8.2%) discharged with permanent disability and 18(6.7%) died. Using multivariable Binomial logistic regression model initial GCS [AOR 0.072(0.01-0.523)], how patient is managed [AOR 19.036(3.555-101.938)], initial hemoglobin level [AOR 0.027(0.002- 0.349)] and complication [AOR 0.054(0.013-0.224)] were found to be significantly associated with outcome of RTA at 5% level of significance. Conclusion: The study included 268 RTA victims. The study revealed 6.7% and 8.2% of patients has outcome of death and permanent disability. Initial Glass coma scale, initial hemoglobin level, how patient managed and presence of complications were statistically significant factors that increase the poor outcome of RTA victims. Key words: Road traffic accident, Pattern of injury, Complications