Background:-Diabetic ketoacidosis is potentially fatal metabolic disorder commonly presentrnin emergency department.It is a life threating complication of diabetes.If it misdiagnosed orrnmistreated it is 100% fatal.rnPurpose:-rnTo study precipitating factors and clinical-laboratory features of diabetic ketoacidosis (DKA)rnatatTikurAnbesa Specialized Hospital Emergency department, Addis Ababa Ethiopia.rnDESIGN:-rnA prospective study by reviewing medical charts.rnSUBJECTS:rnA sampled 103 Adult patients aged 12 years and above with known or previously unknownrndiabetes presentingin the emergency department from January 2011 to January 2013 with arndiagnosis of diabetic ketoacidosis.rn..rnRESULTS:rnMean (SD) age was 30.9 (12.11) years for males and 28.4 (14.4) for females. Majorityof patientsrn77(74.8%) were type I and 23(22.3%) were newly diagnosed. Infection was the leadingrnprecipitating factors 36(45%)and 24(30%) was due to treatment non adherence. Infection sitesrnincludegenito-urinary system, respiratory system and acute febrile illness. Only 11.1% hadrnaltered level of consciousness, when 8% were in coma and 35.9% had dehydration. More thanrnhalf (52.7%) patients hadleukocytosis and 31.4% were hypokalemic.rnCONCLUSION and RECOMMENDATIONrnDiabetic ketoacidosis commonly seen in TikurAnbesa hospital emergency department. It was arnmajor cause of morbidity and mortality. The main precipitant factors of DKA were infectionsrnand missed insulin injections. These factors are preventable in order to improve outcomes ofrndiabetic patients to not to complicate to DKAby improving patient education and access to care.rnKey words: Diabetic ketoacidosis, precipitating factors, clinical and laboratory feature,rnTikurAnbesa