Background: Tetanus remains an important cause of preventable morbidity and mortality in developing countries. There is paucity of data on the pattern of tetanus among adults in south east Nigeria. Objective: The aim was to review the patient characteristics, risk factors, clinical features, treatment and mortality among adult patients with tetanus in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, with a view to reinforcing measures to address any identified risk and poor prognostic factors. Methods: This is a retrospective study of all adult patients managed for tetanus in the medical wards of the NAUTH Nnewi between 1st January 2005 and 31st December 2009. Results: Nineteen patients were managed for tetanus in the medical wards of NAUTH out of a total of 5336 patients admitted in these wards during the study period. The male: female ratio was 2.8:1. Their ages ranged from 20-75 years with a mean of 44.8 ± 18.4 years. The lower limb was the commonest site of injury (n=6; 31.6%). None of the patients was fully vaccinated against tetanus. Case fatality rate (CFR) was 52.6%. There was a trend towards increasing CFR with increasing age (t= -1.8, p=0.09). Duration of hospital admission was significantly shorter among patients who died when compared to those who survived (t=4.8, p<0.001) Conclusion: Tetanus, a vaccine-preventable disease remains a public health challenge in Nigeria with a high CFR. Health education of the public and health care provider action to ensure full and up-to-date vaccination of all adults, as being done in most developed countries, should be vigorously pursued to prevent further avoidable deaths from tetanus. Key Words: Tetanus, adults, south east, Nigeria.