Background: Audible clinical alarms have been an essential part of patient monitoring since the 1950s.rnAlarm fatigue is the desensitization of a clinician to an alarm stimulus that occurs when caregivers arernexposed to a great number of repeated alarms. Due to a number of clinical alarms from medicalrnmachines within the ICU, there is a high risk of nurses becoming desensitized to the sound of patientrnalarms. Moreover, physiologic alarms may be disabled, silenced, or ignored. These practices canrnpotentially affect the patient care negatively.rnObjectives: To assess the nurses' level of knowledge of alarm fatigue, practices towards alarms andrnassociated factors among nurses working in adult ICUs of federal government hospitals in Addis Ababarncity, Ethiopia, Jan-Jun 2020 G.C.rnMethods: A descriptive cross-sectional quantitative study design was conducted to determine thernknowledge of alarm fatigue, practices towards alarms and associated factors among nurses working inrnAdult ICUs of federal governmental hospitals in Addis Ababa, Ethiopia from Jan -Jun 2020 GC. A totalrnof 162 nurses was recruited by the convienience sampling method. The data were collected by usingrnsemi structured, self-administer questioner. SPSS version 25 for Windows was used for data entry andrnanalysis, descriptive statistics and bivariate and multivariate logistic regression were used to analyze therndata.rnResult: In this study, 42% of participants had poor practice towards alarms and 57.8% have goodrnpractice. The majority of, 107 (66%) respondents had good knowledge on alarm fatigue. The majority ofrnnurses 140 (86.4%)answered correctly that Non actionable/nuisance alarms disrupt patient care. Nursesrnwho donâ€™t have in service training on alarm management are 2 times, having a poor practice than thosernwho took in service training (AOR=1.974, 95% CI (1.296, 4.024)).rnConclusion and Recommendation: Although the improvement of nurses' knowledge and practicesrnregarding alarm management will directly or indirectly reduce the harms related to poor alarmrnmanagement, Nurses have remarkable gaps and alarming skill performance related to alarms. Therefore,rnperiodic on-job and pre-service training regarding alarm management, guidelines as well as protocolsrnshould be provided to all ICU nurses. There is also a need for further research to include more settingsrnwould be valuable. In addition, there are gaps identified for further research to strengthen findings.