Background Intestinal obstruction is a global problem consuming much in terms of surgical services. It is a common surgical emergency and a significant health problem in Ethiopia. Several factors contribute to poor management outcomes in the case of intestinal obstruction. Post-operative mortality rate ranges from 3% to 30%. Despite this high rate of mortality, there is no recently published literature that has explored Intestinal Obstruction and its associated factors at Chiro General Hospital. Methods Institution based cross-sectional study was conducted among 254 of patients admitted with Intestinal obstruction who treated surgically at Chiro General Hospital. Data were collected using checklists from individual patient cards by trained three BSc nurses from 13 to 18 July 2018 and completeness of data collection was checked every day by the principal Investigator. Data were entered to Epi-Data version 3.1 computer software and exported to SPSS statistical software version 22 for analysis. Bivariable binary logistic regression was used to saw the association between each independent variable and dependent variable. All variables with P-value < 0.2 during bi-variable analyses were considered for multivariable logistic regression analyses. Odds ratio along with 95%CI were estimated to measure the strength of the association. Level of statistical significance was declared at p value less or equal to 0.05. Results In this study the magnitude of unfavorable outcome of Intestinal Obstruction was 21.3% (95% CI: (16.5, 26.4). Age group of 55 years or above [AOR=2.9, 95%CI: (1.03, 8.4)], duration of illness of 24hrs or above [AOR=3.1, 95%CI: (1.03, 9.4)], pre-operative diagnosis of gangrenous SBO & gangrenous LBO [(AOR=3.6, 95%CI: (1.3, 9.8)), (AOR=4.2, 95%CI: (1.3, 13.7))], respectively were significantly associated with unfavorable outcome. Conclusions The magnitude of unfavourable management outcome of patients with Intestinal obstruction who treated surgically in this study was high. Old age, late presentation of illness and gangrenous bowel obstruction were significantly associated with unfavourable management outcome. So that early detection prompt management of patients with Intestinal obstruction reduce the occurrence of unfavourable outcome of patients.