Background: Bacterial bloodstream infection is the major public health problem which leads to high morbidity and mortality of patients. Early diagnosis and appropriate treatments of bacterial blood stream infections are the best approach to reduce the patients' are becoming worsen conditions and to prevent the developments of drug resistance bacteria. The aim of this study was to determine the bacterial profile of blood stream infections and their antibiotic resistance pattern in Addis Ababa, Ethiopia.Methods: Records of 500 patients blood culture result from Clinical Microbiology laboratory unit of Addis Ababa Regional Laboratory was reviewed from January, 2015 to December, 2016. Data was entered and analysed by using SPSS version 20.0 statistical software and results were expressed using frequency and percentages. Tables and graphs were used to summarize the results. The chi-square test was employed to assess the association between variables. A p-value of less than 0.05 was considered as statistically significant.Results: Out of 500 blood culture results reviewed, among these the frequency of blood culture positive was 164 (32.8%). Out of a total 164 isolates, 127 (77.4%) were gram-positive bacteria and 37 (22.6%) were gram-negative bacteria. The predominant bacteria species isolated comprise Staphylococcus aureus 82 (50.0%), Coagulase negative staphylococci (CONS) 43 (26.21%), Klebisella pneumoniae 23 (14.02%), Escherichia coli 6 (3.6%), Acinobacter baumannii 4 (2.4%), Streptococcus species 3 (1.8%), Pseudomonas aeruginosa 2 (1.2%) and Nesseriae meningitidis 1 (0.6%). Generally, in this study majority of gram-positive isolates showed high resistance to commonly used antimicrobials to Penicillin(83.5%),Trimethoprim-sulphamethoxazole (83.5%), Erythromycin (77.3%), Doxycycline (76.5%), Tetracycline (76.5%), Gentamycin (75.0%), and least resistant to Clindamycin (5.4%) and Chloramphenicol (46.1%) and high resistant gram-negative isolates was seen to Ampcillin (88.5%),Amoxicillinclavulanic acid (80%), Trimethoprim-sulphamethoxazole (80%), Ceftriaxone (77.1%) and least resistant to Ceftriaxone (42.8%) and Cefepime (51.5%). In this study it was also revealed that isolated bacteria species developed multi drug resistance to most of the antibiotics commonly tested. Conclusions:In this study the overall blood culture positive bacterial isolate rate was high (32.8%). The most predominant blood culture isolates were Staphylococcus aureus, Coagulase negative staphylococci and Klepsiella pneumonia. Antibiotic resistances of isolates were alarmingly high so that proper management of patients with blood stream infections needs careful selection of effective antibiotics.