A one year (January 1-December 31, 2000) prospective study of consecutive HIV seropositive patients admitted to the medical wards to Tikur Anbessa Teaching Hospital was made to determine the morbidity, mortality, and spectrum of HIV-associated disease among medical inpatients. During the study period, there were 1813 medical admissions and 568 hospital deaths. Of the medical inpatients, 566 were tested for HIV-1 antibody because of clinical suspicion and for treatment decision. Of these, 237(42%) patients tested positive and this accounted for 13% of the annual medical admission. The male to female ratio was 1.4:1. The mean age +/- SD was 32.8 +/- 8.9 years with a range of 17-70 years. The mean length of hospital stay was 27.5 days (range: 0.5-103 days). Ninety two percent (218/237) of the patients were in WHO clinical stage IV at the time of hospital admission. Thirty one percent(73/237) of the patients died in hospital during the study period, accounting for 13%(73/568) of the annual hospital deaths among medical inpatients. Tuberculosis, central nervous system mass lesion suggestive of CNS toxoplasmosis, and sepsis were the three most common disease complexes among admissions and deaths. It is, therefore, recommended that similar studies estimating disease burden at different levels of health care system be made so as to assess the overall morbidity and mortality associated with HIV/AIDS in the country.