Introduction: The ina ppropriate use of emergency department (ED ) ser vice by patients withrnnon - emergent cases is a worldwide problem that makes it difficult to guarantee access for real rnemergency cases, decreases willingness for care, produces depressing run over effects on thernquality of emergency services, and raises overall costs. rnObjective: The study was to assess inappropriate emergency visits of patients in TikurrnAnbessa Specialized Hospital adult emergency from M arch 18/ 2019 â€“April 10 / 2019 G.C, in rnAddis Ababa, Ethiopia. rnMethodology: Institutional based cross - sectional study was conducted from March to April/rn2019 G.C in Tikur Anbessa specialized hospital adult emergency unit. The data was collected rnthrough interviewing using a pretested & structured questionnaire & chart review of thosernpatients was also done by using check lists. rnResults: Out of 295 eligible participants, 63.8% were females, 51.6% were in the age grouprnof 31 - 60 years, 52.3% had low family income status, 56.4% had an educational level of rndiploma and above, 77.7% were with chief compliant of medical or surgical illness & the 22.3% sustained trauma / injury. Two hundred twenty seven (79.1%) participants hadrnduration of illn ess >24 hours, 34.5% came from regular OPD and 9.1% came to ED with an rnambulance. Majority of ED visits also occurred during working days (85.4%). Among totalrnrespondents, 117(40.8%) of them had inappropriate ED visits. Sex, family income, duration rnof illness and days of visits had significant associations with Inappropriate ED visits ofrnpatients. rnConclusion : In Tikur Anbessa Specialized hospi tal significant number of patients hadrninappropriate ED visits based on our in appropriateness criteria developed from ACEP & rnAfilaloâ€™s criteria of appropriateness of ED visit of patients; Participants with female sex, lowrnfamily income , >24 hours duratio n of complaint and working days ED visits had more rninappropriate ED visits of TASH. rninappropriate ED visits of TASH.