Introduction: Globally, injury continues to be an important cause of morbidity and mortality both in the developed and developing countries. It is the major public health problem in every country across the world and causing approximately 5.8 million deaths per year. The Chest trauma is a disease that has worsened long with growing urbanization and industrialization; due to worldwide increases in violence, constructions and vehicle number. Objective: The objective of this study was to assess the patterns and outcomes of chest injuries among adult patients admitted with chest trauma in Tikur Anbessa specialized teaching hospital (TASTH) over one year period between January 1, 2016 to December 31, 2016. Methods and Materials: Hospital based retrospective descriptive cross- sectional study designs were used to assess magnitude and outcomes of chest injury among patients admitted to TASTH. The collected data were to Epi data software version 3.3.1. Then, the entered data was exported to SPSS, version 21 for analyses. Descriptive statistics was used to present the results. Logistic regression was used to determine association between dependent and independent variables. Association between variables was taken as statistically significant for all variables resulted in p- value of <0.05 on multiple logistic regression. RESULTS: A total of 192 chest injury patients were treated at TASTH. Fifty three of them were died during treatment. Age [AOR 8.9(95% CI, 1.51-53.24)], time of presentation to hospital after injury [AOR 4.6(95% CI, 1.19-18.00)], Length of stay in hospital [AOR 0.12(95% CI, 0.02- 0.58)], presence of extra-thoracic associated body region injury [AOR 25(95% CI, 4.18-150.02)] and development of complications [AOR 23(95% CI, 10-550)] were determinant of mortality in the present study. Conclusions and recommendations: Chest trauma predominantly affects the male and economically productive age group with high morbidity and mortality in this environment. Road traffic accident was the leading cause of chest trauma in this study outcome. The study calls for early recognition and management of complications, awareness creations to society on their health seeking behavior, adequate provision of ambulance service and road traffic accidents prevention to reduce the morbidity and mortality resulting from chest injuries. Key Words: Injuries, Chest injuries, Tikur Anbessa Specialized Teaching Hospital, Ethiopia