Background: Globally and Sub-Saharan Africa country still now childhood mortality rates remainrnhigh. In Ethiopia, child mortality rates dropped 71% from 1990 to 2015, however it is still aroundrn184,000 Ethiopian children die each year. More deaths of children in hospital often occur within thernfirst 24hrs of admission. Many of these deaths occur from preventable causes. The most causes arernpneumonia, diarrhea, circulatory impairment, severely mental function altered and sepsis.rnObjective: To assess causes and associated factors of pediatric emergency mortality in pediatricrnemergency unit at Tikur-Anbessa Specialized Hospital in Addis Ababa city, Ethiopia.rnMethodology: A five years retrospective study review of pediatric mortality from neonate to 13 yearsrnwas conducted at the pediatric emergency unit. The data was entered to epi-data version 3.1 softwarernand the data was exported to Statistical Package for Social Science Version 20, then result analyzedrnby using descriptive statistics, Pearson chi-square, and logistic regression. Final result was displacedrnby graph, tabulation, texts and pie-chart.rnResult: This study found that from 12,240 pediatric patients that entered to admitted pediatricrnemergency unit only about 449(4.1%) documented as death outcome with 107(31.7%) of earlyrnmortality rate. The average mean of study participant age was 37.46 months and more mortality raternfound among neonate age group 69(6.5%). A 298(88.2%) of pediatric emergency mortality was due tornmedical emergency cases that more consists cardiovascular diseases and respiratory diseases. Aboutrn146(43.2) primary cause of death was concomitant with secondary causes of deaths. Malnutrionrn60(41.1%) was the most leading causes of co morbidity with primary causes. Early mortality wasrnstrongly significant association with late come to ED (AOR=1.865, CI=1.103-3.152, P= 0.020) andrndiarrheal diseases (COR=0.221, CI=0.054-0.903, P=0.036).rnConclusion and recommendation: In this study Pneumonia 60(17.8%), Congestive heart failurern46(13.6%) and sepsis 40(11.8%) were the top causes of pediatric emergency mortality in pediatricrnemergency unit. So that early identifying and intervention is very important to decrease pediatricrnemergency mortality