Background: Cardiogenic shock is defined as a state of ineffective cardiac output caused byrnprimarily cardiac disorder resulting in inadequate tissue hypo perfusion. Cardiogenic shock is one rnof the contemporary emergency room and cardiology challenges. The mortality rate is 39 % withrnrange of 27-50%.It is also the leading cause of mortality in patents with myocardial infarction. rnObjective: The main objective of the study was to determine the clinical characteristics ofrncardiogenic shock patients in Black line specialized hospital adult emergency room. rnMethods: This study was conducted in Black lion specialized hospital located in Addis Ababa,rnEthiopia. A cross-sectional study was conducted retrospectively on patients who visited Black rnLion hospital adult emergency room from June 2019 to June 2021. All patients who wererndiagnosed to have cardiogenic shock on the mentioned study period were included .Data wasrncollected from patients card by the researcher after structured questioner which was be adoptedrnand modified from previous researches . After checking for clarity and completeness the data wasrnentered in to SPSS version 26 for analysis. rnRESULT; In this monocentric study which from 98 patients who were enrolled retrospectively 84rnpatients full fill the inclusion criteria. Out of them patients 39 (46 %) were male. The mean age ofrnthe patients was 40.2 years with 19.1 standard deviation. Regarding the residency 67.9% werernfrom urban area. At admission the mean systolic blood pressure of the patients was 59.23 mmHgrnwith standard deviation of 34. The mean heart rate of the patients was 111 beats per minute with rn37 standard deviation. Ejection fraction of the patients was depressed with mean EF of 39.9% with rn14.4 standard deviation. . Valvular heart disease was the most common underlying etiologyrnaccounting for 47.6% or 40 of the patients, followed by ischemic heart disease which accounts forrn26.51 % of the cases .In hospital mortality was 38.1 %. Presence of deranged creatinine level wasrnassociated with death with p-value of 0.031 and 3.256 adjusted odds ratio [1.116-9.505] 95%rnconfidence interval. Ischemic heart disease was also having association with death with p value ofrn0.004 and adjusted odds ratio of 7.184 with [1.874-27.543] 95 % confidence interval. rnCONCLUSION: In this study the most common underlying etiology for cardiogenic shock wasrnchronic rheumatic valvular heart disease .The other finding was the etiology ischemic heartrndisease and presence of deranged creatinine level were highly associated with in hospital rnmortality.