Introduction: there are many studies regarding informed consent in clinical trials, however, only few studies have assessed adult patient’s knowledge and perception of surgical informed consent in clinical practice. Therefore, the purpose of this study was to assess knowledge and perception of surgical informed consent and associated factors among adult surgical patients in Gondar University Comprehensive and Specialized Hospital, Northwest Ethiopia, 2018 Methods: responses from 312 postoperative adult surgical patients was taken using pretested structured interviewer administered questionnaires for one month. Result: there were a total of 302 respondents, (40% males and 60% females). More than half, 178 (59%) were in age groups of 31-43 years. Of the study participants, 193(63.91%) of them had poor knowledge and 155(51.3%) had poor perception about surgical informed consent in the study area. On the other hand, living in urban, being higher educational status and having past history of surgery were positively associated with good knowledge of patients towards surgical informed consent while being urban, higher education, being ophthalmologic patient & receiving consent from physician were positively associated with perception of patients regarding surgical informed consent. Conclusion: majority of the study participants had limited knowledge and poor perception about surgical informed consent. Adequate preoperative health education for patients should improve patients’ knowledge and perception. Keywords: Gondar University Comprehensive Specialized Hospital, Knowledge, patient perception, surgical informed consent