Background: In medical scenarios like cancer parents level of participation in treatmentrndecision for their child to enhance a better outcome is significant. Though in Ethiopia little isrnknown about the decisional role of parents. Due to that this study aimed to clarify the extent tornwhich parents involve in treatment decision making for their child and also explores differentrnfactors that determine the treatment decisional role.rnObjective: To assess parental role and associated factors in pediatric cancer treatment decisionrnmaking at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia 2020 GC.rnMethods: A total of 167 parents were enrolled in the cross sectional study using a censusrnmethod and additional 11 parents were purposively selected for the qualitative phenomenologicalrnstudy. The study was employed from April to May 2020 G.C. at Tikur Anbessa SpecializedrnHospital Pediatric Oncology department. Quantitative data was entered to EpiData version 4.6rnand exported to SPSS version 25 for analysis. Descriptive frequencies and percents were usedrnand binary logistic regression assessed statistical association. After the qualitative in-depthrninterview the data was transcribed and translated to Amharic then analyzed using thematicrnanalysis method. ATLAS .ti 7 software was employed to aid coding process.rnResult: The actual role of parents in treatment decision making was 129(77.2%) for passive,rn37(22.2%) for collaborative and 1(0.6%) for active. Also 138 (82.6%) of the participantsrnreported having their preferred role. Interpersonal trust and parental informational preferencernwere statistically significant factors. Three broad themes were identified for factors affectingrnparental role in treatment decisional role in the qualitative study which are parent health carernprovider relationship factor, parental factors and clinical factors.rnConclusion and recommendation : Parental role in treatment decision making was found to bernpassive and multitude of factors were identified affecting their roles so there needs to bernimprovements in enhancing more roles for parents.