Abstract Background:Hypertension and type II diabetes are major cardiovascular morbidity and mortality risk factors in the world, especially in the low and middle income country which includes Ethiopia. The objectives of this study was to assess factors that a ecting hypertension and type II diabetes jointly at Debre Tabor Referral Hospital; Northeast, Ethiopia. Methods:A hospital-based retrospective cohort study was conducted on 151 regular followup patients aged 18 from January 2017 to January 2019. In the study three di erent model were used; Thus, multivariate analysis were used for analyze association of two response over a time; multivariate growth curve analysis were used for determine number of follow-up and its e ect; Lastly multivariate multilevel analysis were used to identify the risk factors of hypertension and type II diabetes. Results:The mean age of the patients was 47.4 years and 57.6% of them were females. The association between SBP and DBP were 0.446, 0.427, 0.407, 0.394, 0.385 and 0.379 over the six follow-up respectively. Likewise the association of SBP and T2DM, DBP and T2DM were also slightly decreased over a time. Beside from the six follow-up, only the rst four follow up were statistically signi cant and in each follow-up the multivariate response were decreased by 5.175, 0.690, 0.092, 0.012 unit respectively.The study shows that their is a signi cant intercept variation(u 0i =13.9967, p<0.0001 and e =254.11, p<0.0001) and slop variation(u =-0.412, p=0.0088) for number of related disease, baseline stage of SBP and baseline stage of DBP. On the xed estimate the variable age, residence, number of related disease, baseline stage of SBP, baseline stage of DBP and baseline T2DM were signi cantly associated for both hypertension and type II diabetes; but gender was associated only for type II diabetes by considering P<0.05. Conclusion: The ndings in this study conducted that hypertension and type II diabetes are becoming a serious public health concern in the country. Hence, intervention measures should be undertaken at the community level; particular emphasis should be placed on prevention by introducing lifestyle modi cations and creating awareness about the problem so that early detection and intervention is possible. Keywords: hypertension, type II diabetes, cardiovascular disease, Ethiopia, Debre Tabor 1i 0i