Background rnThe major assessment tool that is of use in Ethiopia to diagnose and treat depressive disorders isrnDSM 5. However, DSM -5 might not represent the diverse symptomatology of depression in arncountry with diverse ethnic and cultural background. Having a clear knowledge of the type ofrncommon presentations or complaints of patients with depression coming to outpatient services inrntertiary hospitals has significant implication for clinicians to provide appropriate patient care. rnObjective rnTo identify the common presenting symptoms of depressive disorders among patients who camernto receive outpatient care for depressive disorders in tertiary hospitals in Addis Ababa. Anotherrnobjective is to identify common symptoms along the domains and to investigate its associationrnwith sociodemographic factors of the study participants. rnMethod rnA cross sectional facility-based study design was used. The study participants included patientsrnwho visited outpatient psychiatric services in 3 tertiary hospitals in Addis Ababa in the past 2rnyears, by mainly focusing on patients who are currently visiting the OPDs and going back up to 2rnyears until the sample size was reached. Potentially eligible patients were selected by filteringrnthose who have been diagnosed with depressive disorders. Then, using the inclusion andrnexclusion criteria samples were identified until the sample size which was needed reachedrnstarting from the most recently recorded patient (consecutive sampling). Consecutive patientsrnwere recruited starting from those currently on follow up to until about those who were seen inrnthe past 2 years at least once. Study participants were interviewed through Face to Facerninterview. Descriptive statistical methods were used to summarize the collected data and to helprnus understand the collected information. The most distressing symptom domains were analyzed.rnCross tabulation was done to see association between sociodemographic and symptom domains. rnResults- Feeling down, depressed or hopeless were the most frequently endorsed symptomsrnoccurring in >90% of the patients. All items were rated with fainting spells being the lowest rnrated occurring in only 10.9% of the patients. At least one symptom was seen in 98.8% of themrnfrom somatic domain, 96.4% from affective, 93.3% from other and 78.2% from cognitiverndomains. From the patients who reported most distressing symptoms, around 58(35.2%) of themrnmentioned symptoms from the affective domain as their most distressing symptom, 46(27.8%) rnrnmentioned symptoms from somatic domain, 21(12.7%) mentioned two or more symptomrncombinations from different domains, 12(7.2%) from cognitive and 1(0.6%) from other domain. rnConclusion- Above 90 % of the study participants reported to have symptoms from the 3 domainsrnof depression which are affective, somatic, and other. Around 78% of the patients also reported tornhave one or more symptoms from cognitive domain of depression. When expressing symptomsrnwhich are most distressing to them, significant proportion of the patients reported symptoms whichrnare combinations from all the 4 domains of depression. Symptoms which are not included in DSMrncriteria and screening tools being used in clinical setup are shown to be reported in high frequencyrnand also as most distressing in this study.