Background: Residual neuromuscular block is a relatively common and often unrecognized complication of general anaesthesia in the post-anaesthesia care unit. Furthermore, it is the major contributing factor for patient's morbidity. The aim of this study was to assess the incidence and associated factors of residual neuromuscular block among patients underwent general anaesthesia at University of Gondar hospital Methods: A hospital-based observational study was conducted from March 15 to April 30/2016. A total of 384 patients were included in the study. The presence/absence of residual neuromuscular block was assessed within the first 20 minutes of PACU admission using double burst stimulation. Associated factors and sign symptoms of adverse respiratory events were also collected. Univariate analysis was performed descriptively using the Mann-Whitney U test for comparing Continuous variables. Chi-square test and Fishers exact test were used for comparing proportions. Bivariate and multivariate logistic regressions were used to identify associated factors. Results:The overall incidence of residual neuromuscular block was found to be 12.9%. The age of patient, being female (AOR=3.5, 95% CI;1.789-6.857), intraoperative high cumulative dose of muscle relaxants (AOR=1.23, 95% CI;1.12-1.35), and use of pancuronium (AOR=5.14, 95% CI;1.16-22.797) were factors associated with residual neuromuscular block. A total of 107(28.08%) patients had ARE. Conclusion and recommendation:residual neuromuscular block was a severe complication of general anaesthesia in the study patients. Adverse respiratory events are common in patients with residual neuromuscular block. We recommend use of intermediate acting muscle relaxants.