Introduction: Preoperative fasting is necessary to lower the risk of aspiration duringrnanesthesia. The period of fasting is usually prolonged beyond the recommended time forrnvarious reasons and affects patientâ€™s comfort. Current guidelines recommend a more relaxedrnpolicy which allows fluid intake up to 2 hours before surgery. rnObjective: To assess preoperative fasting time and associated discomfort in adult patientsrnundergoing elective surgery in public hospitals of Addis Ababa, Ethiopia, 2021. rnMethod: A hospital-based cross-sectional study was conducted on 422 adult patients whornunderwent elective surgery at selected public hospitals of Addis Ababa. Data was collectedrnfrom February 20 â€“ May 10, 2021 from medical records and patients by using structuredrnquestionnaire. The collected data was entered into statistical package for social sciencesrn(SPSS) software version 24 for analysis. Spearman correlation was used to assessrnrelationship between preoperative fasting time and discomforting factors. P values of lessrnthan 0.05 were considered statistically significant. rnResults: The mean preoperative fasting time was 14.26 Â± 2.35 h (range 8 - 22 hr) for solidsrnand 13.89 Â± 2.37 h (range 8 - 21 hr.) for clear fluids. Immediately before surgery 64% ofrnparticipants stated that they felt discomfort and factors contributing to discomfort were thirstrn(58.1%), hunger (49%), mouth dryness (49%), lengthy wait prior to surgery (16.4%),rnheadache (22%) and tiredness 38.6%. There was a moderate positive correlation betweenrnpreoperative solid fasting time and severity of hunger (rsrn rn(420) = .46, p < .oo1) and mouth dryness (rsrn rn(420) = .37, p < .oo1), thirst (rsrn rn(420) = .32, p < .oo1) in this study. rn Conclusion: The mean fasting time was 6.95 times longer for clear liquid and 2.38 timesrnlonger for solids than the American Society of Anesthesiologist recommendation.rnPreoperative fasting duration had association with Preoperative discomforting factors.