Backgroundand Aims: Pericardial effusion can cause significant symptoms and diminished quality of life, but more importantly, is associated with increased risk of cardio respiratory failure, mortality and death. The etiology of pericardial effusion variesin different parts of the world and is related to the relative prevalence of different diseases. It is caused by a variety of local and systemic disorders, or maybe idiopathic. The etiology of pericardial effusion varies in different parts of the world and is related to the relative prevalence of different diseases. Methods: This is a retrospective study where data from all the cases admitted with pericardial effusion in the Department of Cardiology July 2021 August 2022at BSM Medical University Hospital were included. Altogether 110 cases diagnosed with pericardial effusion established y Echocardiograpy were included. Evaluation for the cause of pericardial effusion was done. Iatrogenic (cardiac surgery, catheterization) and post-traumatic cases and age <15 years were excluded. Demographic profile, common causes, the presentation and the clinical outcome of the patients were documented. Results: This study included 110 patients with age ranging from 15 to 81 years, majority of patients ware aged between 56-75 years (n=44, 40%). Only 14 patients 12.7% admitted with pericardial effusion of the age group between less than 25 years. 57 (51.8%) were male and 53 patients (48.26%) were female. 78 (70.9%) belonged to middle socioeconomic status while11(10%) belonged to poor group. The average number of hospital day was 6.78 days (Range 1-23 days). Most common etiology of pericardial effusion was tuberculosis (56.3%) followed by heart failure (10.9%), Hypothyroidism (6.3%) and malignancy (5.4%). Tachycardia was the most common ECGfindingin77(70%) followed by Low voltage ECG in48 (43.6%). The most common clinical feature was breath lessness in 84.5% followed by tachycardia in 56.3% of the patient. Conclusion: Tuberculosis, Heart Failure and Hypothyroidism were the common causes of Pericardial effusion with male predominance. Breathlessness was the most common presenting symptom.