Background: rnPostoperative sore throat is one of the most frequently reported symptoms following tracheal rnintubation. It has several risk factors that include demographic features as well as clinicalrnaspects. Two aspects stand out regarding the anesthetic management, endotracheal tube (ETT)rncuff pressure and cuff size. The ideal range for ETT cuff pressures is typically between 20 to 30rncm H2O. Despite this objective measurement of the cuff pressures is not done and professionalsrnmostly rely on manual methods of estimation, often with less accuracy.rnObjective: rnThe objective of this study was to compare the incidence and severity of post-operative sore throatrnin patients when endotracheal cuff pressure will be monitored and adjusted versus the conventionalrnpilot balloon palpation technique. rnMethodology:rnThe study was conducted at Tikur Anbessa specialized Hospital in Addis Ababa, Ethiopia. Arnhospital based analytic cross sectional study was conducted involving 100 patients. Patients 18rnyears and older scheduled for gastrointestinal, gynecology, thoracic, orthopedic, neurosurgery andrnopen urology and ENT elective surgery under general anesthesia with ETT at Black lionrnspecialized hospital between August â€“ November , 2020 were recruited. Patients were grouped inrnto two and in the first group patients had their ETTc initially inflated, checked by a cuff pressurerngauge, recorded and then set to 25 cmH2O. In the second group patients had their ETTc inflatedrnusing the pilot balloon palpation method. Patients were then followed up for post-operative sorernthroat at 24 hours post-surgery. Bivariate and multivariate logistic regressions were used torndetermine the association. rnResults: From all of the patients 39(39%) of them had postoperative sore throat within 24 hours.rn44% of patients from the manual pilot balloon palpation group had developed Postoperative sorernthroat while 34% of participants in the monitored endotracheal tube cuff pressure group had it. rnFrom the total patients 51(51%) were male and 49(49%) were female; majorities of them werernfound age between 36-55 and mean age was 44. In terms of patients ASA status most of themrn69(69%) were ASA 2 followed by ASA 1 who were 25(25%), rest 6% ASA 3: above half of rnpatients 72(72%) were laryngoscopic grade1. Majority of surgeries were general surgeryrn(62%).ETT size 6 was used in sixty seven patients (67%) rnConclusion and Recommendation: Patients in whom endotracheal tube cuff pressure wasrnmeasured and adjusted had similar risk of developing postoperative sore throat as compared tornthose patients in which manual pilot balloon palpation technique was used. The analysis based onrnbinary and multiple logistic regression analysis showed that patient age was found to havernsignificant association with development of POST (p-value 0.038, AOR .141 95% CI (.022, .901)).rnA research with a bigger sample size should be conducted on the topic. Also a randomized controlrntrial can be conducted in the future. Simple yet relatively cheap and effective methods forrncontinuous monitoring of cuff pressure such as using arterial line transducers can be applied.