Background: Electrocardiography (ECG) is the graphical display of electrical potentialrndifferences of an electric field originating in the heart. It is a commonly used procedure for therndiagnosis of heart disease. Interpretation of ECG is a core clinical skill in emergency andrncritical care medicine. Only a few studies have been performed to evaluate the ECGrninterpretation skills of general practitioners worldwide. There is no study published until nowrnin Ethiopia on the competence of ECG interpretation among graduating medical students. rnObjective: To assess competency of ECG interpretation among 2018 graduating Classrnmedical students in Addis Ababa University and Haramaya University. rnMethodology: A cross-sectional study was conducted on graduating medical students at AddisrnAbaba University and Haramaya University. Data had collected from October 01, 2018, tornOctober 30, 2018, by using structured questionnaires. Data were entered, cleaned, edited andrnanalyzed by using SPSS version 25.0 statistical software. Descriptive statistics, cross-tabs,rnChi-square, Mann-Whitney U test, and Binary logistic regression were utilized. rnResults: 202 graduating medical students were involved on this study, out of this 61.3%rn(95% CI 56.3 â€“ 66.3%) and 32.75% (95% CI 28.25-37.25) were able to correctly interpret thernprimary ECG parameters and the arrest rhythm of ECG abnormalities, respectively. Thernability to detect from common emergency ECG abnormalities were Anterio septal ST segmentrnelevation myocardial infraction, atrial fibrillation and first-degree atrioventricular block werern42.6%, 39.1% and 32.1% respectively. rnConclusion: This study showed graduating medical students had low competency in ECGrninterpretations.