<p><strong>Background</strong>: Spectrum of skin diseases varies from region to region due to several factors such as genetics, socioeconomic and environmental. This study aimed to determine the pattern of various skin disorders appearing in the dermatology department of a tertiary care hospital.</p><p><strong>Methods</strong>: All patients attending the dermatology clinic of the Hawassa university comprehensive specialized hospital, from January 2017 to December 2018 were included in this retrospective analysis. The medical records of the patients were obtained from registry books. </p><p><strong>Results: </strong>A total of 7727 patients attended the dermatology clinic of HUCSH. Out of these samples, 18.1% of patients repeatedly came to the hospital for a follow up visit related to their diseases, while 81.9% were enrolled as new cases.</p><p>There were more males (51.9%) than females. More than three quarter of the cases were aged above 16 years while less than a quarter were children below 16 years. Eczema was diagnose in 2734 (35.4%), being the most common cause for attendance, followed by infectious disease (23.3%) and disease of the skin appendages (12.1%).</p><p class="abstract"><strong>Conclusions</strong>: Eczema was the most common skin disease seen in our study, followed by infectious disease   and disease of the skin appendages. Concerted effort need to be made to control these conditions and training of the primary health care providers and education of General Practitioners in Dermatology must emphasize these common conditions, with the aim of improving primary health care and alleviating the burden of hospital care.</p>