The common conditions admitted in medical wards include heart failures, stroke, poorly controlled diabetes, chronic liver diseases, chronic kidney diseases and Acquired immune deficiency syndrome (AIDS). The mortality rate of medical admission in developing countries is higher than that in the developed world due to epidemiologic transition, high rate of poverty, illiteracy, late presentation of patients and lack of well coordinated health service delivery. There has not been any study on mortality pattern in medical wards in Abakaliki, Southeastern Nigeria. It is against this background that we embarked on this study of the mortality pattern in medical wards of Alex Ekwueme Federal Teaching Hospital Abakaliki. This was a retrospective observational Hospital based study. The admission, discharge and mortality registers of the Male and Female Medical Wards were used to extract information on biodata, diagnosis, duration and outcome of all admissions from January to December 2019 (12months). A total of 1557 (male-839, female-718) patients were admitted over the study period of 12 months with mortality rate of 11.88%(m: f= 5: 4). Stroke (19%), AIDS/TB (17%), liver (16%), heart (15%), and kidney (7%) diseases were the predominant cause of mortality with non-communicable diseases accounting for 56%. The mean admission duration was 9.32% while 58.38% died within the first week. The mortality rate of medical admission was high with double burden of both non-communicable and communicable diseases and constituted of mainly stroke, HIV/TB, liver, heart and kidney diseases which are essentially preventable. Most of the deaths occurred within the first week of admission.