ABSTRACT rnBackground: - Worldwide, Stroke is the second most common cause of mortality and disability.rnIn Ethiopia stroke is the 5rnthrn cause of death accounting 7% from the top 10causes of death. Postrnstroke neurological deterioration is a significant clinical condition that affects up to a third ofrnpatients. Early neurological deterioration in stroke patients is a common event and is associatedrnwith poor outcomes. Therefore, attempts to prevent and treat early neurological deteriorationrnshould be made promptly and aggressively. Although studies have found that being aware ofrncommon causes of neurological deterioration can help for optimal care and preventive measures,rnso far there is no publication as to the knowledge and practice in identification of earlyrnneurological deterioration and associated factors in stroke patients among health professionalsrndone in Ethiopia. rnObjective: To assess the knowledge, attitude, and practice towards identification of earlyrnneurologic deterioration in stroke patients among health care professionals in Addis AbabarnEthiopia. rnMethods: -We conducted a Facility based cross sectional analysis of data collected from Junern2021 to September 2021 from 214 health professionals who are mostly involved in the care ofrnstroke patients. Participants filled out pretested self-administered questionnaire. It includesrndemographic information, three sections to assess knowledge, practice and attitude towards earlyrnneurologic deterioration in stroke patient. Data was entered in to SPSS version 25. Categoricalrnvariables were summarized by frequency and percentages. Associations were done by binary andrnmultivariable logistic regression to see the association between Knowledge-attitude, KnowledgePracticernandrnPractice-attitude.rn rnrnResults:-A total of 209study participants responded to the study questions among a total of 214rnparticipants making the response rate of 97.6%. Most of the respondents were male 114(54.5%).The meanrnage of the study participant is 29+/- 3.9. Nurses account for largest number of respondents 101(48.3%)rnfollowed by internal medicine residents 46(22%).Majority of respondents 111(53.1%) were from TASH,rn41(19.6%) from Zewditu memorial hospital, The mean knowledge score of general practitioners andrnresidents was 9.3 and the majority of internal medicine and Neurology residents scored above 9.3.Higherrnnumbers of respondents 71.8% have positive attitude towards the causes of early neurologic deteriorationrnin stroke patients could be prevented. Individuals who have training on acute care for stroke patients hadrn2.8 times (AOR = 2.8, CI = 1.4, 6.8) and neurological residents had 6.6 times (AOR = 6.6, CI = 1.2, 7.4 ) rnmore likely to have stroke knowledge. Regarding stroke knowledge level, knowledgeable subjects hadrn2.7 times (AOR = 2.7, CI = 1.3, 3.5) more likely to have positive attitude towards stroke related earlyrnneurological deterioration as compared to those who were not knowledgeable. Healthrnprofessionals below age 24 year were 0.58 times (AOR = 0.58, CI = 0.16, 2.1) less likely to practicernpreventive measures of early neurologic deterioration than those within the age range between 3444.rnrnrnConclusion:-This study leads to the belief that there is a crucial need to rationalize and updaternknowledge regarding the predictors of early neurologic deterioration and preventive measures. It isrnimportant to have and use hospital based protocols to achieve optimum patient outcome and high qualityrnof interdisciplinary care. Assessment to knowledge gap, current practice and attitude helps to fill the gapsrnas well as for provision of comprehensive, interactive and holistic approach to acute care of stroke andrnrehabilitation.