ABSTRACT Background: Multiple organ Dysfunction Syndrome (MODS) is defined as the acute and potentially reversible dysfunction of two or more organs triggered by multiple clinical or non-clinical factors. There is a need to identify the common infections that leads to mortality in intensive care unit. Studies in India have focussed on patients with sepsis due to established causes. Aim and Objective: To know clinical presentation, Etiology and outcomes in patients with multiple organ dysfunction syndrome. Materials and Method : This was hospital based prospective observational study conducted in department of general medicine, Guntur Medical College, GGH, Guntur, for period of two years, in which 100 individuals admitted in ICU with multi organ dysfunction were included in the study. Results: 86% of the patients were form the age group of 31 – 70 years and among that also maximum patients were from 61-70 years of age, 48% of the patients were hypertensive and 32% were diabetic. 87% of the patients were admitted with fever and also with other clinical presentation. , 61% had LRTI, 9% had Bacteremia, 12% had Dengue, 5% had pancreatitis, 2% had Congestive heart failure, 6% had renal failure, 5% had hepatic failure. Among all the study population mortality due to MODS was observed among 26% of the patients. SOFA Score, Duration of ICU, Duration Hospital stay and ventilation use were more among non-survivals compared to survivals. Conclusion: Increase in the severity of organ dysfunction which was assessed by SOFA score is very much associated with higher mortality. Etiology of multiple organ dysfunction syndrome can be influenced by regional and seasonal tends. Rickettsial fever, leptospirosis and dengue are common causes of undifferentiated fever in patients with MODS.