Introduction: Cancer of the uterine cervix is the second most commonly diagnosedrncancer and a leading cause of cancer death in Ethiopia. A substantial proportion of theserncases are diagnosed at a locally advanced stage for which concurrent chemo-radiationrntherapy (CCRT) is the standard of care. Several previous studies reported on the acuternside effects of CCRT and radiotherapy (RT) for locally advanced cervical cancer but fewrnof these studies were from Africa and none from Ethiopia.rnObjective: to determine the incidence of severe acute side effects of RT or CCRT amongrnpatients with locally advanced uterine cervix cancer treated at the radiotherapyrndepartment of Tikur Anbessa Specialized Hospital.rnMethodology: An institution based prospective follow-up study of 57 locally advancedrnuterine cervix cancer patients treated with cobalt 60 RT alone (83%) or CCRT (17%) wasrnconducted. Acute toxicity of the gastrointestinal (GI), genitourinary (GU) system andrnskin was assessed using radiation therapy oncology group (RTOG) acute radiationrntoxicity assessment format weekly during treatment and one month after the end ofrntreatment.rnResult: About 12% of the patients had severe acute toxicity of RT or CCRT. The mostrncommon severe acute toxicity occurred in the lower GI (7%) followed by the skin (5%).rnAmong the 10 patients who received CCRT two had severe acute toxicity while five outrnof the 47 who were treated with RT alone experienced severe acute toxicity.rnConclusion and recommendation: A little more than one sixth of locally advanced stagerncervical cancer patients treated with RT or CCRT in Tikur Anbessa Specialized Hospitalrnhad severe acute side effects of these treatments. Due attention with weekly follow-uprnshould be instituted. Future studies should examine acute and late side effects of theserntreatments separately in a large cohort of patients.