Background: In Ethiopia pre hospital care is not well developed. Apart from some governmental and non-governmental institutions, the pre hospital care is not well known by the community Objective to assess the knowledge, attitude and practice of residents about pre hospital care In Addis Ababa Methodology: household based cross sectional study was conducted using multi stage random sampling technique from March to April, 2014. The data was collected through structured self- administered questionnaire and interviewing technique among 422 participants. Data was entered, analyzed, and interpreted by using SPSS Software version20. Result: The findings of this study shows that majority of the respondents 364 (86.3%) knew the presence of pre hospital care, most respondents 405(96%) believed that pre hospital care is important and 160 (37.9%) individuals had encountered in different levels of pre hospital care provision. 411(97.4%) respondents believed that pre hospital care should be strengthened by increasing number of ambulances (23.7%), by training health professionals (18.7%), by teaching the community about pre hospital care (26.1%) and a combination of the above methods (31.5%). Regarding the assessment of their practice the common care givers during mass casualty were bystanders 102(24.2%) and the least care givers were paramedics being 18(4.2%).The common emergent problems that occurred in Addis Ababa fall down accident 72(29.2%) and followed by road traffic accident 59(24.1%). Conclusion: Knowledge, Attitude and Practice investigations provide helpful insight into the level of understanding and utilization of services within the community .The findings show that high proportions of respondents have good knowledge (76.5%) and, positive attitude (69.9%) of pre hospital care, however, less than half of them have practiced pre hospital care in mass casualty. Unfortunately 58.8% and 65.2% of the respondents did not know the phone number of Red Cross and fire & emergency dispatch center respectively. Recommendation: The city administration should teach the community to improve awareness about the advantages of pre hospital care, ambulance transportation and early visit to a hospital so as to decrease morbidity and mortality of trauma patients. The Red Cross and fire and emergency dispatch center should advertise their phone number to the public and respond immediately to community call and formulate a decision with policy makers about safe and rapid transportation despite the barriers Concerned authorities should be concerned about increasing the number of paramedics and the available Paramedics should actively participate in mass casualty incidents. Based on this study no identified barriers about pre hospital care so that there should be another study by taking other variables