Background: Breast cancer (BC) is the second most common of all cancers and therncommonest in women contributing 12% of all new cancer cases and 25% of all cancers inrnwomen. It is the most prevalent cancer in Ethiopia. Even if the estimation of BC survival isrnbeneficial to improve the current breast cancer care & treatment, studies are lacking inrnEthiopia. rnObjectives: To identify determinants of survival and to estimate cumulative survivalrnprobabilities of patientâ€™s with BC that are diagnosed from 2013-2018 in Hawassa UniversityrnComprehensive Specialized Hospital and Yanet Hospital.rnMethods: A health facility-based retrospective study of 302 patients was conducted. Thernmedian survival was estimated by Kaplan- Meier. Log Rank test was used to compare survivalrnamong groups. Cox proportional hazards model was used to identify determinants. Resultsrnwere repaired as hazard ratio (HR) along with the corresponding 95% CI. Sensitivity analysisrnwas done with the assumption of lost to follow-ups (LTF) might die 3 months after lastrnhospital visit. rnResults: Majorities (83.4%) were presented at an advanced stage. The study participants hadrnfollowed for a total of 4685.62 person-months. Their median survival is 50.61 monthsrn(IQR=18.38-50.80) declined to 30.57 months in worst case analysis (WCA), the outcome ofrn57 patients were unknown (majorities, 96% being advanced stage) and 67 patients were died.rnThe overall survival (OS) of patients at two years is 69.3% (61.30, 76.03) and it declines torn51.3 % in WCA. Rural residence (AHR=2.71, 95% CI: 1.44, 5.09), travel time > 7 hoursrn(AHR=3.42, 95% CI: 1.05, 11.10), duration of symptom 7-23 months (AHR=2.63, 95% CI: rn1.22, 5.64), > 23 months (AHR=2.37, 95% CI: 1.00, 5.59), advanced stage (AHR=3.01, 95%rnCI: 1.05, 8.59) and not taking chemotherapy (AHR=6.69, 95% CI: 2.20, 20.30) werernindependent predictors of death. Through WCA, rural residence, advanced stage of BC, notrnhaving breast surgery, poor adherence to chemotherapy were independent predictors of death. rnConclusion: The 2 years OS is low in Hawassa (69.3% and declines to 51.3% in WCA). Ruralrnresidence, advanced stage and poor adherence to chemotherapy were independentrndeterminants of death. Increasing early diagnosis of BC and access to cancer treatment isrnmandatory.