Gastrointestinal resection and anastomosis is a very common procedure globally. Anastomotic leak is a complication affecting 2% to 10% of patients undergoing gastrointestinal surgery. Different factors have been attributed to the development of leak. This study was designed to assess the prevalence and associated risk factors for anastomotic leakage after sigmoidectomy so that understanding can help in clinical decision for anastomosis following sigmoidectomy, to control factors and to decrease anastomotic leak OBJECTIVE The aim of this study is to assess magnitude of anastomosis leak and associated factor in emergency and elective resection of sigmoid colon and colo colic anastomosis for patients with redundant sigmoid in TGSH and FHRH from 2020 to 2023 METHOD Across-sectional Retrospective descriptive study through patients chart review was conducted from August 2020 to November 2023. Census sampling technique was used. The final sample size for this study is 170. Data collected through data collection tool , entered using EpiData 3.1 and analyzed using IBM SPSS statistics-26 .For independent variable of age, sex ,residence,duration of operation,Comorbidity, Hemoglobin, Type of Surgery and History of Deflation ,both bivariable and multivariable logistic regressionmodel used to analyze correlation of independent factor to the dependent factor at 95 % CI ,P<0.05 RESULTS Among the patients operated a total of 16 patients developed postoperative anastomotic leakage, which makes the prevalence rate 9.6%. There was a statistically significant association between Elevated systolic blood pressure and prolonged intra operative time with the occurrence of anastomotic leakage. Keywords: Anastomotic leakage; Redundant sigmoid, sigmoid volvulus, Public health hospitals, Bahir Dar.