This study was carried out to determine the type frequency, cause and treatment outcome of patients with genitourinary and rectovaginal fistulae at Adigrat Zonal Hospital. A retrospective review of charts and operating room records of patients admitted for genitourinary and/or rectovaginal fistula to the gynecological ward of the study Hospital from April 1, 1993 to March 30, 2001 was conducted. There were a total of 1,011 patients on whom major gynecological surgeries were done in the same period of time in the hospital. Among these 201(19.9%) patients were operated for genito urinary and rectovaginal fistulae. Eight cases were excluded because of incomplete records. Out of the remaining 193 cases, 95.3% were due to obstetric etiology. One hundred sixty six (86%) had vesicovaginal fistula, 16 (8.3%) both vesico vaginal fistula and rectovaginal fistula, 9 (4.7%) recto vaginal fistula, one vault fistula and one vesicouterine fistula. Primigravidae accounted for 47.3% of obstetric fistula and teenage constituted 40% of the cases. Among the patients with obstetric fistula, 92.4% had no antenatal care and 42.4% delivered in health institutions. Of the 182 patients with vesico vaginal fistula, surgical intervention after the first intention was successful in 86.8%, failed in 4.9% and stress incontinence developed in 8.2% of cases. The success rate of fistulae repair in district hospital is comparable to results from specialized setup. Repair integrated into rural hospital services could reduce cost and time spent by patients traveling to specialized units.