Background; Ethiopian Federal ministry of health has published hospital transformation guidelines which contains lists of essential emergency equipment, supplies, drugs and Human resources (Clinical & non-clinical) necessary to provide service in emergency care area. Also Good opportunity made from FMOH to improve access to health service provision by expanding or constructing new facilities buildings to deliver quality care for communities. Additionally FMOH examining challenges and providing chance to local level to address the gap in the whole parts of Ethiopia. Objective; The objective of the study was to assess Emergency care capacity of Dilla University Referral teaching hospital, Gedeo zone ,SNNPR, Ethiopia. Methods: Descriptive Institution based cross-sectional study design was conducted from January 09 to June 07, 2017. This study was conducted at DURTH using Emergency and Trauma Services Resources Assessment Tool for Ethiopia. This assessment tool was modified from the general (ESRAT) to (ETSRAT-Ethiopia) by Emergency and critical care directorate in FMOH. Data was entered in excel, results of the study was organized and presented using tables, and; the following statistical analysis was considered .Such as Frequency, percentage. Results : The study demonstrated that emergency care capacity findings were ; nearly 67?% of emergency care personnel, and 70% of emergency medicine were available in the hospital, but only 43% emergency drugs were available in emergency care area. 36% over all emergency equipment indicator, 21% of emergency care supply, 75% of emergency care area laboratory indicator & 88% of system (routine) indicator were available in emergency unit of DURTH. Conclusion & Recommendation; The findings reveal extreme deficiency of essential emergency equipment, supplies & drugs. Additionally there were shortage of emergency care health personnel & lack of job specific training. Therefore Dilla Hospital stakeholders should take measure to fill the above listed gaps. In Addition, FMOH & appropriate stakeholders should assist to fulfill the gap