Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second cause ofrncancer death worldwide. It is a major public health problem and continues to be a disease of bothrnthe developed and developing nations. The objective of this study was to determine five yearâ€™srnsurvival and associated factors among patients treated for CRC at adult oncology unit of TikurrnAnbessa Specialized Hospital (TASH). A hospital based retrospective cohort study wasrnconducted and all patient charts with diagnosis of CRC from September 11, 2013 to Septemberrn10, 2014 were included for the study and tracked until September 10, 2019. The data was enteredrnand analyzed using SPSS version 23.0. Survival curves were plotted using Kaplan-Meier methodrnand prognostic factors for survival were determined using Cox regression model. Out of the 316rnCRC patients, 181(57.3%) were male with 1.34 ratio. The mean age in years was 48.66 + 13.58.rnMajority 115 (36.4%) of the patients were diagnosed with colon cancer, whereas, 112 (35.4%)rnand 89 (28.2%) patients were diagnosed with rectal and colorectal cancer respectively.rnApproximately, half (45.60%) of the patients were diagnosed at clinical Tumor Nodes Metastasisrn(TNM) stage-IV and 203 (64.2%) of patients were dead in the five years follow-up period withrnmedian survival of 19 months. The result of cox proportional hazard regression analysis showedrnthat, being underweight (HR=1.72, 95% CI (1.19-2.48)), rectal cancer (HR=1.92, 95% CI (1.382.68))rnrnand late stage of CRC (HR=2.71, 95% CI (1.67-4.41)) were associated with decreasedrnsurvival. This study reflects that most patients diagnosed with CRC at TASH werernpredominantly presented at advanced stage and treatment outcome was poor compared to manyrnAfrican studies. Hence, a concerted effort has to be made to improve access to specialized rnmedical faculties and public health education programs on CRC, which may be necessary for rnearly detection and thereby improve treatment and CRC survival.