ABS     TRACT BACKGROUND፡ Intensive Care Unit (ICU) is a special unit where critically ill patients who require advanced respiratory or hemodynamic support are admitted. Little has been published about surgical intensive care unit patients in Ethiopia. The aim of this study was to assess the pattern of admission and treatment outcomes of adult surgical patients admitted to the Intensive Care Unit at St. Paul’s Hospital Millennium Medical College (SPHMMC).METHODS: A two-year retrospective medical record review of all adult surgical patients admitted to Intensive Care Unit at St. Paul’s Hospital Millennium Medical College .RESULTS: Surgical patients made up 91(22.1%) of 411 admissions of adult intensive care unit.Of these, 82 (M: F = 1.5:1) patients were analyzed. Age ranged from 16 to 82 years with a mean age of 43 years (SD +/-18.2). Emergency admissions accounted for 70(85.4%) cases. The top three primary admission diagnoses were generalized peritonitis secondary to perforated viscus (25,30.5%), bowel obstruction (21,25.6 %) and trauma (13,15.9%). Acute respiratory failure (38,46.3%) and septic shock (23,28.0%) were the leading indications of intensive care unit admission. Most patients (62,75.6%) received mechanical ventilatory support.The mean length of intensive care unit stay was 7.3 days (SD+/-5.2).Death occurred in 33(40.2%) patients. Mortality was higher in those who stayed for 48hours (OR=5.6;95% CI 1.60-19.69; p=0.007) and in ventilated patients (OR=5.3; 95% CI 1.41-19.98; p=0.013).CONCLUSION:The observed mortality in this review was higher than the one in most reports. It was significantly high in patients who stayed for 48 hours and in those who required mechanical ventilatory support.KEYWORDS: Intensive care unit, surgical admission, outcome