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Effective communication between nurses and physicians is essential in providing safe and effective care. Even if high-quality patient care is the goal of medicine and nursing, patients are dying and experiencing preventable complications because of poor nurse physician relationship. The main objective of this work was to assess perception of nurses & physicians towards barriers to nurse-physician communication and its impact on patients outcome at Hawassa University referral hospital. An institution based cross sectional study was carried out and included nurses and physicians who were working at Hawassa University referral hospital. Both nurses and physicians participated in the study have perceived that effective nurse-physician communication have positive impact on patient outcomes. Negative correlations were also existed between factors affecting nurse physician communication and patient outcomes. On the other hand nurses were not satisfied with their relation with physicianswhere as physicians were relatively satisfied with their relation with nurses...