Background: Pheochromocytomas are catecholamine-secreting tumors, the majority of whichrnarise from the adrenal medulla. Untreated, they are potentially lethal; early diagnosis and treatmentrnoffer a good chance of cure. It accounts for 0.2% of patients with Hypertension in western world. rnLimited data exists regarding pheochromocytoma in developing world. Knowing diseaserncharacteristics and presentation in this unstudied population helps to diagnose pheochromocytomarnearly. rnObjectives: The objective of this study was to review the disease characteristics and managementrnoutcome of patients with pheochromocytoma among patients who were evaluated in TikurrnAnbessa Specialized hospital, Addis Ababa Ethiopia over a 10-year period. rnMethodology: Institution based retrospective cross sectional study design was used and allrnpatients with pheochromocytoma evaluated from 2010 to 2020 medical records were reviewed,rnpertinent data was collected and analyzed using SPSS 26. Frequency tabulation, Chi square test,rnbivariate and multivariate logistic regression and Pearson correlation were used to study thernrelationship among different variables. rnResults: Twenty-eight patients were included in the study, of which 43% were male and 57%rnfemale. The mean age was37 years (range 16â€“67). Incident of diagnosis was after the patients werernsymptomatic in 75% of patients and after incidental discovery of adrenal mass in 25% of patients.rnThe median tumor size was 6 cm, and mean of 5.8Â±1.6cm, 30% were larger than 6 cm. 75% werernlocated in the adrenal gland (n=21, 71% unilateral, 3.6% bilateral), and 21.4%(n=6) were extraadrenal.rnThernmostrncommonrnextrarnadrenalrnsiternwasrnrnintra-abdominal paraganglioma (n=4, 14.3%).rnThere were 3 patients (10.7%) with malignant pheochromocytoma as suggested by imagingrnfeatures and recurrence. Clinical diagnosis of pheochromocytoma associated genetic syndromernwas made in 3(10.7%) patients, MEN 2a in two patients and vHL in one patient. Surgical cure raternamong symptomatic pheochromocytoma patients was 93.5% (n= 15). Although No significantrnpredictor of risk of malignancy or risk of recurrence was found in this study, the trend was towardsrnhigher risk of recurrence for patients who are male and symptomatic at the time of diagnosis withrnextra adrenal location of the tumor. On the other hand, being not operated was associated with increased risk having persistent symptoms (AOR: 58 P value: 0.006) and being older age atrndiagnosis (AOR: 0.7 P value: 0.04) was associated with decreased risk. rnrnConclusion and recommendation: Majority of patients with pheochromocytoma arernsymptomatic with classic symptoms, targeted screening with goal of early detection and surgicalrnmanagement is recommended. Large scale study with prospective follow up is necessary to knownrnthe burden of this rarely reported potentially malignant neoplasm.