Background: - Nurses are critical in the delivery of essential health services and are core in strengthening the health system. So, the aim of this article was to assess the prevalence of the communication skills of the nurses to patient and determinant factors in Amhara Region Referral Hospitals, Ethiopia, 2019 Methods: Institution based cross-sectional study was conducted from March 18 to April 16, 2019 in Amhara Region Referral Hospitals. A simple random sampling technique was used to select 684 respondents. Data was collected using pretested and self-administered questionnaire. Collected data was entered into Epi Info version 7.1.2.0 and exported to SPSS version 25.0 for analysis. Bivariate analysis was used primarily and variables with p-value ≤ 0.2 were further examined using multivariable logistic regression model to control con-founders. Then, variables having p-value less than 0.05 with 95% CI were used to determine associated factors. Results: - Out of 678 study participants, 403 (61.4%) of them had effective communication skills with 96.8 % of the response rate. Less than 5 years of working experience [AOR=2.77; 95% CI: (1.28, 5.99)], workload [AOR=1.52; 95% CI: (1.09, 2.12)], and poor evidence-based utilization [AOR=2.00; 95% CI: (1.40, 2.85)] were associated with the nurse’s effective communication skill to patients. Conclusions: More than half of the participants were had effective communication skills. Year of working experience, workload, and poor evidence-based utilization were the main contributing factors of the communication skills. Keywords: Communication skills, Nurses, Patients, Ethiopia