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ABSTRACT   Background: Patients’ care when dispensing of Medicines could be ensured through the delivery of drug information either orally or in written form. Pharmacists are expected to ascertain that patients or caregivers have gained clear and complete information. The objective of this study was to assess patient counseling during dispensing of medicines and associated factors in Tikur-Anbessa Specialized Hospital. Method: A cross sectional study was conducted to assess patients’ counseling and a convenient sampling technique was employed to select study participants. Data was collected using a structured questionnaire and observation checklist and, analyzed by using SPSS version 20. Descriptive statistics and odds ratio were used to present study results. Results: A total of 286 respondents were included in this study. Most (93.7%; 94.4%; 91%) of the respondents were told the drug unit dose, frequency of administration and duration of therapy respectively. Less than a third of the patients received information on drug-drug interactions, storage of medications and side -effects.  None of the patients were told what to do on missed dose and, none were asked back to repeat their understanding. Three fourth of the patients reported that they were satisfied with the counseling services provided. Females were more likely to be satisfied than males whereas, level of education showed a negative association with pharmacist counseling services.  Conclusion: Drug dose, frequency of administration and duration of therapy were the most frequently delivered information to patients. Gender and level of education have significant association with medication counseling service in the study setting. Key words: Counseling, OPD Pharmacy, Tikur-Anbessa Specialized Hospital