Background: Onychomycosis a chronic nail infection caused by dermatophyte, yeast, and non-rndermatophyte molds, is one of the most usual forms of people disease, Onychomycosis in adultsrncontribute around 50% of wholly nail illnesses. Nail mycoses give until 2-9% global and itsrnoccurrence is regularly growing mainly in poor state. Even though Onychomycosis is minorrnillness, it affects patient psychology and also it is expensive disease by means of absenteeism fromrnjob due to seeking medication and also it has job discomfort. Regardless of recent advanced in therndevelopment of anti-fungal drugs and theraprny Onychomycosis is still difficult to treat conventionalrntreatments often fail and it has been suggested that many reasons such as age, peripheral vascular rndisease, nail growth, poor drug penetration into the nail lesions and fungal growth patterns rnadversely affect clinical result. rnObjective: This research was designed to assess the prevalence of Onychomycosis and spectrumrnof fungal etiologic agentâ€™s associate with the nail mycosis among patients attending at Rankrndermatologic clinic from February-July 2019 G.C Addis Ababa, Ethiopia. rnMaterial and methods: The present study was a single institutional cross-sectional study wasrnconducted among a total of 200 patients visiting dermatology clinic from Feb 2019 to July 2019rnat Rank dermatology clinic in Addis Ababa. Nail scrapings that was collected from studyrnparticipants following standard procedure. A small amount nail scraps specimen was put on a slidernthen added droplet of 20% KOH and stay for a minimum of 5 minutes, then detection wasrnperformed by direct microscope for the positive or negative of fungal pathogen. The rest of nailrnscraped of evrnery specimen was inoculated on culture media. At same time culture processed forrnevery positive or negative result of detection. Every nail scraps specimen was inoculated on twornpetredishe Mycosel agar and Sabouraudâ€™s dextrose agar prepare with antimicrobial antibiotics butrnnot added cycloheximide. All culture media performed based on the manufactureâ€™s guide and rninoculated media stay at room temperature (25-30 C 0) aerobically and put the inoculated plate by rn rn rninverted part up to six weeks. The processed media which incubate in the incubator were checked rn3 times per week for the presence or absence of any growth. Culture growth supposed forrndermatophytes were sub-cultured onto potato dextrose agar to generate pure isolate. Molds werernfound by investigative macroscopic and microscopic analysis. Microscopic detection of Moldsrnwas done by small amount from growth culture putting to new slide and added lactophenol cottonrnblue reagent then cover by a cover slip and examined by microscope. Yeast investigation of C.rnalbicans by performed by germ tube production. Datarnwas evaluated by performing excel and SPSSrnversion 20 software. rnResults: Out of 200 nail scrap samples processed, 161(80.5%) yielded significant Onychomycosisrnof which 106(65.8) obtained from female patients and 55(34.2%) were from male patients. Thernages of research participant were from 2 to 72 year. From 200 study participant, 61(30.5%) fungalrnelement was detected by direct microscopy whereas 161(80.5%) nail scraps specimen was isolatedrnby culture and Six specimens become negative for culture whereas positive by KOH detection.rnNon dermatophyte were the main pathogen that contribute 99(61.5rn %) after that mixed pathogenrnin 26 (16.1%) patient and then dermatophytes were identified in 22(13.7%) next by yeasts thatrncontributed 14(8.7%) of the isolates. Aspergillus fumigatus was the predominate fungal pathogenrnidentified from non-dermatophytes and from dermatophyte, T.mentagrophyte was the leadingrnfungal pathogen and also Candida albican was the chief fungi identify from yeast. rnConclusion: The prevalence Onychomycosis was high, that was 161/200 (80.5%). However non-rndermatophytes were the most common causative agents for Onychomycosis, dermatophyte andrnyeasts fungi also representing the reason for Onychomycosis are diverse. Clinical diagnosis, directrnmicroscopy and culture isolate are essential for appropriate analysis. These highlight the need forrnnationwide study on the spectrum.