Background: Now a dayâ€Ÿs road transport system is one of the sign of modernizat ion and rnit has a large economic and social impact. In global reports motorcycle is representingrnhigh number of road users and has high number of crash statistics. Globally Accidentsrninvolving motorcycle riders have varied consequences. Motorcycle riders had increasedrnfrequency and severity of extremities injury. Most injuries among motorcycle riders arerndiagnosed in the extremities. Motorcycles injuries (MCIs) are underreported fromrndeveloping countries. In Ethiopia Prevalence of motorcycle accident in southern Ethiopiarninjuries was more than half of all traffic related injury. rnObjective: To assess prevalence and pattern of extremities injury following motorcyclernaccident in Dilla university referral Hospital, Gedeo Zone Dilla Town in 2020 G.C.rnMethodology: Institutional based cross sectional study design with retrospective datarncollection was applied. Censes sampling technique is used. The data was collected byrnchart reviewing of motorcycle injury patient from from Sep/11/2017 to Aug /7 /2019 byrnusing checklist. The data analysis was done by SPSS version 25 software. rnResult and conclusion: - The prevalence of extremities injury was 452 extremities injuryrnper 1000 motorcycle accident population. Lower extremities injury was higher inrnpercentages than upper extremities, which were 56.9 % and 28.9% respectively. Softrntissue injuries were the commonest injury of all, it took 80.3%. Laceration took 28%.rnFrom all extremities injury fracture was 45.2%. The percentage of fracture of Tibia,rnFibula and femur were 21.8%, 20.1% and 8.4% respectively. Also Ulna, radius andrnhumorous were 5.4%, 5.4%, and 3.3% respectively. The highest type of fracture wasrntransverse fracture, which was 29.7%. The second type of fracture was oblique, whichrnwas10.9%. Motorcycle accident is the most devastating injuries that could lead tornmorbidity even death. Dilla university referral hospital has higher burden of motorcyclernaccident. Extremities injury was the worrying case of motorcycle accident.