Background: Trauma is the second leading cause for lower and upper limb amputation worldwide. In developing countries, majority of patients who sustained trauma does not visit health facility immediately after they sustained it. The main reason identified for complications of amputation was associated with high medical problem and economic burden for healthcare system and poor quality of life, reducing this problem is a global priority. Objectives: To identify the management outcome of amputation and associated factors at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia, 2017. Methods: Hospital based document review was conducted at Hawassa University Comprehensive Specialized Hospital Orthopedic ward that were managed from October 2017 to April 2018. Data was collected using data abstraction checklist. The collected data were entered in to Epi data 3.1 software and transferred to SPSS version 20 software for analysis. Association between independent variable and treatment outcome of amputation was assessed by using logistic regression model. Statistical significance was taken as P –value < =0.05. Results: Overall unfavorable outcome of amputation was 32.5%. Infection was the most common unfavorable outcome. Pre-operative anemia, pre-operative fever, co morbidity, post-operative leukocytosis, length of hospital stay more than 14 days and level of amputation were significantly associated with unfavorable outcomes. Pre operative anemic (AOR=4.27 95% CI: 1.93-9.45) , pre operative fever (AOR=3.65 95% CI 1.53-8.7), co morbidity (AOR=5.62 95% CI 2.62-12.1), pos operative leukocytosis (AOR=4.43 95% CI 2.01-9.75), length of hospital stay more than 14 days (AOR=8.27 95% CI: 4.28-15.16) , above knee amputation (AOR=2.5 95% CI 1.1-6) and below knee amputation (AOR=3.96 95% CI 1.82-9.75) was significantly associated with unfavorable outcomes. Conclusion: From this study, unfavorable outcome of amputation is comparable to other studies. The unfavorable outcome was highly attributed to pre-operative anemia, pre-operative fever, co morbidity, level of amputation, post-operative leukocytosis and length of hospital stay greater than 14 were identified associated risk factors of unfavorable outcomes.