Background: Genitourinary fistula is public health importance in low and middle incomerncountries though it has been neglected. It has multiple health adversities to women. It is mainlyrncaused after lack of timely and appropriate intervention mainly cesarean section. Butrngenitourinary fistula can be Iatrogenic because of medical error during obstetric andrngynecological surgery like cesarean section and hysterectomy. rnObjectives: This study assessed the trend, major surgical procedures resulted in iatrogenicrngenitourinary fistula and its risk factors. rnMethods: a facility based cross sectional study design was deployed. A mixed method thatrninvolved both quantitative and qualitative study was done. The study included respondentsrnretrospectively using their medical history from January 2005 to December 2019 at Addis Ababarnfistula hospital, Addis Ababa, Ethiopia. All Iatrogenic genitourinary fistula patients who fulfillrnthe inclusion criteria and registered by the Addis Ababa fistula hospital over the study periodrnwere included in the quantitative study while clinicians and care providers who were providingrnservice in the facility during the study period considered for the qualitative study. Data wasrncleaned and analyzed using SPSS version 20.0 software. Descriptive statistics such asrnfrequencies and graphs were used. Results were shown using frequency tables to showrnSociodemographic characteristics of fistula patients and frequency of iatrogenic genitourinaryrnfistula by type and by cause. Bar graphs and pie chart was also used. Time trends in incidence ofrniatrogenic genitourinary fistula were analyzed using linear regression analysis. Annual percentrnchange and average annual percent change were calculated using joinpoint regression analysis onrnjoinpoint regression program version 4.8.0.1. Binary logistic regression model applied to identifyrnrisk factors associated with iatrogenic genitourinary fistula. Crude odds ratio and adjusted oddsrnratio with 95% CI reported. Analysis of qualitative data was done using open code softwarernversion 4.02 to code and categorize data.rnResult: Total 9229 fistula patients treated at Addis Ababa fistula hospital, of which 643(6.96%)rnand 8,586(93.03%) were iatrogenic genitourinary fistula and obstetric fistula cases respectively.rnThe mean age of iatrogenic genitourinary fistula patients was 30.02 Â± 4.625 years (Range, 17-45rnyears) and the mean age of obstetric fistula patients was 26.65 Â± 6.534 years (Range, 14-42rnyears). 341(53%) had iatrogenic genitourinary fistula after cesarean section while, 131(20.4), 78(12.1%), 93(14.5%) were after repair for ruptured uterus, hysterectomy for ruptured uterus andrngynecological hysterectomy respectively. A significant rising trend in iatrogenic genitourinaryrnfistula was found from 2005 to 2019 (1.55% to 52.9%; p