A one-year (April 1st 2003-March 31st 2004) prospective descriptive study of orthopedic admissions to Tikur Anbessa University Hospital (TAUH) was made in order to determine the burden of musculoskeletal conditions together with the present provision of care. A total of 824 patients were admitted of whom 576 were males and 248 females (M:F 2.3:1). The median age was 15 years (range 3 months to 80 years). Trauma was the cause for admission in 507 (61.5%), with road traffic accidents accounting for 211 (41.6%) and a fall for 195 (38.5%). 'Elective' patients waited for an average of 33.5 days for their admission. The mean duration of stay in hospital between admission and elective operation was 11.7 days. The post-operative stay was 20.6 days and the average length of hospital stay of all patients admitted was 35.4 days. The bed occupancy rate was 97.4% with an average time between the discharge of one patient and the admission of another (turnover interval) of 24 hours. Eighty-seven percent of the patients (97/112) who had previously visited a traditional healer presented with a chronic infection, a neglected or a complicated fracture or an advanced tumor. Eleven patients died (1.4%). Health education in the community and of traditional healers, together with a reduction of road traffic accidents would significantly reduce morbidity and mortality in Ethiopia. Major attempts must be made to reduce both the length of time patients wait for elective surgery after being admitted and their post-operative stay in order to serve more people. But it is vital to continue to teach conservative management of fractures as these will be the only methods available for the foreseeable future in hospital outside the centers of excellence. A series of specific recommendation are made to improve our care of orthopedic and trauma patients. We also suggest a broad based community study with an orthopedic input, which would help to produce a better profile and sound decisions to enable this to be achieved.