Aim: To determine and describe the causes and risk factors predisposing Ethiopian patients to rhegmatogenous retinal detachment (RRD). Methods: A retrospective study of all patients with RRD seen at the retina clinic of Menilik II Hospital, Addis Ababa, from April 1999 to October 2003 was done. Charts of patients with the diagnosis of RRD were collected and data were filled on structured questionnaires and analyzed using EPI INFO 6 software. Results: Data were available for 276 patients (305 eyes) in whom the diagnosis of RRD was made. Age of patients ranged from 7-85 years; mean age was 41 and median was 40 years. Hundred-eighty-eight [68%] of the patients were males and 88 [32%] were females with male-to-female ratio of 2.1:1. Myopia was the predisposing factor for RRD in 78 [28.3%] patients of which 63 had myopia of > 5D. In 57 [20.7%] patients with RRD, there was a history of ocular trauma. Thirty-nine [14.2%] patients had had cataract surgery with lens implantation and 21 [7.6%] patients were surgically aphakic. Macula-off RRD was seen in 225 [73.8%] eyes. Bilateral RRD was seen in 29 [10.5%] patients. Conclusion: The study showed that myopia, ocular trauma, pseudophakia and aphakia in decreasing frequency were the main risk factors associated with RRD among Ethiopians attending a tertiary eye care centre.