Background: Appropriate and effective management of acute postoperative pain has been one of the major challenges worldwide and the majority of patients admitted to hospitals still suffer from uncontrolled postoperative pain. Objective: To assess acute postoperative pain management and associated factors after elective surgery among adult patients. Methods: A prospective cross-sectional study was conducted on 198 adult surgical patients from February 25/2020 to May 25/ 2020 with response rate of 96%. Descriptive statistics performed to determine incidence of postoperative pain. Multivariable binary logistics regression was held to identify the associated factors and a P-value <0.05 was considered as significant. Result: Among 190 patients, 100 (52.6%) of patients were inadequately treated at 24 hours of postsurgery. The overall incidence of moderate to severe postoperative pain after elective surgery with in the first 24 postoperative hours was 69.5% [95% confidence interval (CI): 63%-76%]. History of previous surgery [adjusted odds ratio (