Background: This research report explains the prevalence of femoral shaft fractures and management outcome among adults managed at KCMC orthopaedic department. Also it explains the proportion, the major risk factors, the patterns and the age distribution by years. This encompassed all the patients who have been managed at KCMC orthopaedic department from 1st January 2015 to 31st December 2015 in regard to inclusion criteria drawn below. Objectives: The study objectives were to determine the prevalence of femoral shaft fractures and management outcome among adults managed at KCMC orthopaedic department from 1st January to 31st December 2015. This included the demographic characteristics, the causative factors and the pattern of fractures among the specific objectives whose answers were detailed in the report. Methodology: Hospital based cross sectional retrospective study was used to answer both broad and specific objectives. The study area was KCMC, orthopaedic department, whereby patients 154 (N= 154) aged above 18 years with femoral shaft fractures and management outcome were included in the study while those who are out of age range with femoral fractures, pathological fractures and those in the age range with other fracture types were not included in the study. Results: In this research 154 cases were included in the study; the study results showed that, femoral shaft fractures contribute a large percentage of all the fractures of the femur. It accounts for about 83.2% of all the femoral fractures. The active age group (young adults) is the most affected, despite that the elderly group is also significantly affected to a lesser extent. Males comprise more than three quarter (79.2%) of all the cases being diagnosed with the femoral shaft fractures at KCMC orthopedic department. MTA and falls were the main causative of the FSF. However the comminuted pattern of fracture seemed to be leading rather than the transverse fracture, which has been seen to be inversely in other studies. Conclusion: The present study showed that there is high prevalence of femoral shaft fracture, so the government should provide road safety education starting from primary level in order to create awareness to decrease the occurrence of accident which can result to FSF. Most of patients with femoral shaft fracture who were managed at KCMC orthopaedic department complaints with knee stiffness after management, accounted about 33.3% of all patients with complications. So the department should emphasize all patients with femoral fracture to attend physiotherapy early after management.