Most zonal hospitals in Tigray are among the oldest hospitals in the region, now serving for the hugernpopulation of the region that were originally established about 40 or more years ago for a much lesserrnpopulation. Through time the significant increase in population growth has resulted in an extremelyrnincreased demand for health services, while the hospital capacity and facilities are not correspondinglyrnchanging. Different efforts are on process to fulfill the hospitals with the right manpower, medicalrnequipment and other facilities to meet the needs of the clients. However the level of clients satisfaction isrnnot known since no systematic study was carried out to assess the condition.rnA cross sectional study was conducted from November to April 2006. A combination of methods wasrnused in collecting data for this study. These were both the quantitative and qualitative techniques. Threernzonal hospitals were included in the study by simple random sampling technique. A total of 422rnrespondents were recruited for the study selected by systematic random sampling technique in the zonalrnhospitals. Structured questionnaire was used to collect the data in the zonal hospitals. In addition, FGDsrnwith the clients and In depth interviews with the key personnel of the selected hospitals were alsornconducted to gather information. Epi6 and SPSS 10.0 statistical packages were used for datarnmanagement.rnAmong the clients, 52.6 % are male, 40.5% of the total clients are illiterates, 45.3% are from the ruralrnareas and 33.6 % are non paying. The findings of the study showed that the client satisfaction level withrnthe outpatient departments in the zonal hospitals was 43.6 %. Satisfactionrnwas rated highest with courtesy and respect by the health workers with 93.8 % satisfaction rate.rnDissatisfaction was rated highest by respondents with the lack of drugs and supplies in thernhospitals pharmacies with 64.9% reporting dissatisfaction. Nearly half of the respondents (46.7 %)rnresponded they were not satisfied with the information provision by the health workers about thernservices and their health problems. 96 % of the clients got a prescription for drugs and supplies. Of thosernwith the prescription paper, only one third (32 %) got all the prescribed drugs and supplies. 44.2 % of thernrespondents were dissatisfied with the overall waiting time to get the hospital services.rnIn conclusion, many clients were found to be dissatisfied with the services of the outpatient departmentsrnof the zonal hospitals. In addition the FGDs and In depth interviews showed that clients dissatisfactionrnwas associated with the lack of drugs and supplies, long waiting time and inadequate informationrnprovision like that of the factors identified during the exit interview. Thus, the level of clientsâ€™rnvirndissatisfaction is high. Therefore revising the allocation of budget for the hospitals to enable them keeprnthe basic drugs and supplies and reassessment of the functions of the special pharmacies in the hospitals,rnImproving and strengthening the existing information provision to clients and developing a new hospitalrnstructure is recommended.rnKey words: - Hospital, Out patient department, satisfaction