OBJECTIVES:  The aim of this study was to assess the impact of IP of antithrombotic therapy (AT) on patient discharge outcomes of elderly patients. METHODS:  This was a retrospective cohort study done in Internal Medicine ward of Gondar University Hospital (GUH) between May 1, 2013 – April 30, 2014. RESULTS:  Of 156 patients, 100 patients had a good (improved) prognosis and the remaining participants (56) had a poor (no change, worsened or dead) prognosis. Patients who had worsening of medical conditions (91.67%) and dead (69.23%) had higher IP. Based on the Kaplan Meier survival curves (Figure1), there was a significant difference in survival between patients with IP and those with appropriate prescriptions (Log Rank test, P = <0.001). Multivariate Cox regression analysis showed that absence of both antiplatelet and anticoagulant medications (HR = 0.019, CI (0.001 – 0.322), P = 0.006) and presence of PIM (HR = 5.391, CI (1.203 – 24.156), P = 0.028) independently predicted mortality in all patients. Presence of stroke on admission (AHR = 8.368, CI (2.117 – 33.081), P = 0.002) and presence of IP (P = 0.001) like PIM (AHR = 3.093, CI (1.302 – 7.347), P = 0.011), PPO (HR = 4.203, CI (1.615 – 10.943), P = 0.003) and having both PIM and PPO (AHR = 6.908, CI (1.981 – 24.089), P = 0.002) independently predicted poor discharge conditions. CONCLUSIONS:  Poor discharge outcomes were high among hospitalized elderly patients who have been exposed to at least one IP of AT during hospitalization. Admission due to stroke and IP of antithrombotics (under/over prescription or both) were found to be risk factors for poor discharge outcomes. Appropriate strategies to optimize antithrombotics therapy should be sought by physicians.