Background: Prenatal development can be considered as normal or abnormal. Abnormalrndevelopment occurs because of interference of normal development from genetic disorders, rnenvironmental factors or the combination of genetic and environmental factors during therncritical period of embryogenesis with which the neonate is born with a disorder that is describedrnas congenital anomalies. Congenital anomaly is a series of structural, functional and metabolicrnabnormalities present at birth because of several causative agents during critical period ofrnintrauterine life. rnCongenital anomalies highly contribute to abnormal intrauterine development that leads tornprenatal disturbance and postnatal morphological defects that may persist throughout life.rnAccording to World Health Statistics, about 260,000 neonatal deaths worldwide are caused byrncongenital anomalies. The frequency of congenital anomalies in developing countries includingrnEthiopia is underestimated because of the deficiencies in diagnostic capabilities and lack ofrnreliability of medical records and health statistics. Instead, the available recorded diagnoses inrnvital health statistics relay on obvious illnesses, rather than on preexisting congenital anomalyrnpresent at birth contributing to infant mortality and morbidity leading to the significantrncommunity problem. Therefore, it is vital to evaluate types, prevalence, incidence andrnpredisposing risk factors which may provide a baseline for public health plan, suggestingrnprotective strategies against congenital anomalies and establish genetic counseling if the defectsrnare of genetic origin and provide input for further investigation. rnObjective: To assess the prevalence, incidence, types, and patterns of congenital anomaliesrnor disorder at birth and associated risk factors among newborns in southwestern Ethiopia rnMethods and materials: The study was conducted in southwestern Ethiopia. This researchrnused quantitative study methods and genetic analysis. The quantitative methods included rninstitution based retrospective cross-sectional, descriptive cross-sectional and case-controlrnstudy. The study was conducted from 2011 to 2015 during which 45,951 deliveries werernattended for the retrospective document review study. All records of births that occurred in thernselected hospitals during the study period were identified from medical records. Descriptive cross sectional study was also conducted in those six selected hospitals from 2016 to 2018,rnduring which 35,080 deliveries were attained. A prospective registration of all delivers of anyrngestational age during the study period was conducted to determine the incidence of congenitalrnanomalies. Newborns either still or life birth was evaluated for the presence of any congenitalrnanomalies. Data was collected using structured and standard checklist. Case-Control study wasrnconducted on newborns and their mothers within the period of 2016 to 2018 in those selectedrnhospitals. Data were collected after evaluation of the neonate for the presence of congenitalrnanomalies using the standard pretested checklist. The data was analyzed using SPSS versionrn25.0. P