Background: Since advancement of science and technology in the area of laboratorymedicine in 21st century thedesign of laboratory should be organized into high flexibilityzones and need an open plan to support the dynamic nature lab testing by manual or semi-automated or fully automated. The most difficult issue in design of laboratory is allocationand organization of space. Although well design laboratory is in place, it will becompromised if the ergonomics workstation and workflow of laboratoryarenot designedwell. In Ethiopia there is no baseline information on laboratory design, ergonomicsworkstation, and workflow sited on literature.Objective: To evaluate the ergonomic workstation, workflow and laboratory design inclinical laboratory inAddis Ababa,Ethiopia.Method: A cross-sectional study design was used. Quantitative method and directobservationwere conducted.Result:Ergonomics: Work-related musculoskeletal complaint was strongly associated withpoor ergonomic workstation. A one year increased in work experience and age of employee,the odds in favor of compliant were estimated to be increasedby a multiplicative factor of1.374 and 0.921 respectively.A total of 117 ergonomics workstation was evaluated. Theoverall workstations mean score was 1.95 and66.6% of workstation found a mean score oftwoand belowwhich indicate poor ergonomic conditions.Workflow:A total of 28 specimen collectionworkflowand 26 chemistry laboratory workflowwere identified. A total of 8 non-valued added steps were recognized from the existedchemistry laboratory workflow.The average timeofsampleswaitingat reception prior todelivery to respective laboratorieswere decreased as moresamplescollectedwithinshorttime interval.The average cycle times of 489 blood sample drawing process were 3.58minutes and 76.5% (374) ofblood samplesweredrawnwith an average cycle time of 1.0 to5.0 minutes.Atotal of 1231.31 minutes were identified as non-value added (waste) time fromexistedworkflow of chemistry blood samples testing process and seven non-valued addedprocess stepswere recognized. Clinical chemistry laboratoryprocess cycle efficiency was56.6%. Laboratory design: The adjoining and adjacent matrix principles were notdocumented in assessed laboratories.The laboratory design didn`t show the direction ofevacuation plan during emergency situationand fire extinguisher were not strategicallyrnplaced and free of obstruction. Black lion hospital laboratoriesdidnothave anymechanicalventilation system.Laboratory andnon-laboratoryactivities were not separated.Conclusion and recommendation:Hospital laboratories should aware of ergonomicsprincipleand applicationand whenevernew laboratory equipmentpurchaseorder in place itwould have beenmuch better to consider the three factors:quality, cost and ergonomicspecificationof product. Laboratory employees shall modifyorreconfigureor reposition theworkstationor equipment to fit the work to yourself not you to fit towork and by doing thispossible to prevent associated musculoskeletal disorders. Concerning the workflow,laboratories should identified non-value added process or steps or activities and byeliminating those wastes and implementinga powerfulbusiness improvement tools like leanmethod possible tomaximized customer needs.Laboratories must assess their workflowperiodically to identify wasteful practicesand focused only value-added activity to increasetheprocess cycle efficiency and productivity.rnWhenever laboratoryconstruction orrenovationat the stageandprior to design, identifyingthesize and nature of laboratory test being performed,laboratory workflow,number and sizeof laboratory equipments needed, type and numberof ergonomicscasework and countertops,number of sinks available, aisles betweenworkstation andequipments, position of utilitycords,plumbing fixtures, location of safety station, emergency evacuation plan, number andsize of doors and windows, access control areas, and the like should be identified andcalculatedin detailearly in planning and programming phases of laboratory design.rnFurthermore, Laboratory proximity programming and functional relationship betweenlaboratories and reception should be determined early in design process and laboratorymoduleunit space size determinationand open plan laboratorytogether with lean laboratorydesign should be consider in design process. Finally, laboratory manager, engineer,architecture, hospital administrator, other relevant individual must be part of laboratorydesign construction and renovation team.