Background: Tracheal intubation is a rapid, simple, safe and non-surgical technique to achievernairway patency, protects the lungs from aspiration and permits leak free ventilation duringrnventilation while surgery is undergo. But it may associate with adverse events. Determining itsrnmagnitude and associated factors are paramount in making smooth tracheal intubation. rnObjective: To assess magnitude and associated factors of tracheal intubation related adversernevents in Pediatric surgery at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia rnMethods: Institutional based cross sectional study was conducted among 310 pediatric patientsrnwho underwent surgery from December 30, 2019 to February 30, 2020 at TASH Addis Ababa,rnEthiopia. Systematic random sampling technique was used for selecting the study participants. rnPrepared questionnaire was used for data collection. Variables that were found to be (p value ofrn< 0.25) on binary logistic regression entered into a multivariable logistic regression analysis tornidentify independent predictors of tracheal intubation related adverse events. Level of statisticalrnsignificance was declared at p-value less than 0.05. rnResult: During the study period, 310 intubations occurred in pediatric patients who underwentrnoperation room for pediatric surgery intubations were eligible for the study. In our study thernoverall incidence of trachea intubation related adverse events among pediatrics patients whornunderwent surgery was 36.5 %. Output of multivariable logistic regression revealed that, beingrnneonate (AOR of 4.134(1.266-13.498), emergency surgery (AOR of 3.392(1.415-8.132),rndifficult intubation (AOR of 4.083(1.017-7.501)), intubation without using premedication (AORrnof 1.759(1.452-10.83)), intubation without using muscle relaxant (AOR of 1.811(1.103-8.142))rnand trachea intubation attempted more than three (AOR 3.921(2.164-7.396)) were asrnindependent predictors of trachea intubation related adverse events rnConclusion and recommendations: The incidence of trachea intubation related adverse effectrnin pediatric surgical patients is high. Being neonate, presence of difficult intubation, intubationrnwithout using medication and paralytic drugs, emergency surgery, and multiple attempt ofrnintubation might be the predictors of tracheal intubation related adverse events. Anesthetistrnshould consider these factors during trachea intubation.