Background rnThe incidence of acute leukemia is increasing worldwide. In Ethiopia, in terms of incidence among allrncancer cases, it ranks fourth and fifth in men and women respectively. Despite acute leukemia being thisrnprevalent nationally and even a more concerning issue in Tikur Anbessa Specialized Hospital(TASH) thernlargest hemato-oncology center in the country, there have been only few studies done on this area so far. rnThis study is important to have a contemporary data on the clinical presentation and outcome of acuternleukemia patients and helps to put a light on gaps of acute leukemia care in for further detailed studies. rnObjective rnThe Main objective of this study is to define clinical profile and treatment outcome of all patients abovernthe age of 12 years and admitted with the diagnosis of acute leukemia at TASH from January 1, 2015 tornDecember 31, 2017. rnMethods rnThe study design is a retrospective cross sectional study which was conducted at TASH from June, 2018rnto October, 2019. Structured questionnaire was use to collect data from medical record chart of patientsrndiagnosed with Acute leukemia TASH from January 1, 2015 to December 31, 2017. Descriptive analysisrnand frequencies were done using the software IBM SPSS statistics data editor version 25 .0. rnResult rnThere were a total of 235 patients above the age of 12 and diagnosed with acute leukemia and admitted tornTASH from January 1, 2015 to December 31, 2017. Out of these patients, 59.1% had AML, 40% hadrnALL and 1 patient had a Bi-lineage leukemia and 1 other had unclassified leukemia. Males wererndominant with M: F ratio of 1.58. Majority of patients were young in the age category between 12-30rnyears. The commonest FAB subtype of AML and ALL were M4 and L2 subtypes respectively. Therncommonest presenting symptom was symptoms of anemia (94%) and the commonest sign was pallorrn(89.4%). The commonest laboratory finding was anemia (96.2%) followed by thrombocytopenia (94.9%).rnMajority (64.6%) of patients had leukocytosis. rnAbout 53.6% of patients were started on chemotherapy. Among these, 79.3% took intensive inductionrnregimens while 12.7% patients took palliative treatment only. The commonest induction protocol used forrnALL was CALGB, for Non M3 AML was 7+3 and ATRA+ Chemotherapy for patients with AML M3.rnPatients with AML had CR rates of 63.3% whereas ALL patients had CR rates of 92.9%. Default ratesrnwas 10.9% and induction death rate was 28.2% which w has high. The most common cause of death wasrnneutropenic sepsis followed by intracranial hemorrhage. The rate of lost from follow up was very highrnwith only 6 patients currently alive and on follow up. rn rnConclusionrnThe clinical presentation of patients with acute leukemia generally similar with most findings in the rnliterature. However, acute leukemia occurred at a very young age compared with other studies. There is arnvery high early and induction mortality but comparable CR rates to most centers.