OBJECTIVES: The aim of this study is to assess the pattern of cardiovascular diseases and associated factors in outpatient department of cardiac clinic of Gondar university referral hospital. METHODS:  A retrospective cross-sectional study was employed to describe pattern of cardiovascular diseases among patients registered and started follow-up at the outpatient chronic illness clinic of Gondar University Referral Hospital during the period from October, 2010 – October, 2015. The data was collected from August, 2015 till December, 2015.The collected data were cleaned, entered and analyzed in SPSS for Windows version 20.0. Chi square and binary logistic regression was performed to test significant difference among predictive variables and cardiovascular diseases. RESULTS: Out of 1105 patient medical records 862 fulfilled the inclusion criteria. Majority of the patients were females (65%) and living in urban (62.7%).Two third (65.2) of cardiovascular patients were above 50 years old and a quarter of CVD patients were in age range of 50-59. In 37.7% of patients headache was the reason for first time visit to hospital and to be diagnosed for CVDs. Hypertension accounts for the majority (62.3%) of cardiovascular patients followed by heart failure (23.9%).Dyslipidemia (86.2%), Hypertension (72.8%) and Ischemic heart diseases (73.2%) were associated with urban residency(p<0.01). Patients from rural (COR=1.306(1.026-2.166), AOR=1.272(1.017-2.030)) and patients with additional illnesses (COR= 1.813(1.279-2.782), AOR =1.551(1.177- 2.705)) were more likely to poor cardiovascular disease outcome by the physician assessment on their last follow up (p<0.05, CI- 95%). CONCLUSIONS: Hypertension was found to be the most frequent cardiovascular disease followed by heart failure; and hypertensive heart disease was the leading cause of cardiac diseases. Most of the patients had improved assessment by their physician on their last follow up, but patients from rural and with Comorbidty conditions were risks to increase poor cardiovascular outcome.