Forty-four patients had undergone pericardiectomy in Tikur Anbessa Hospital, Addis Abeba, Ethiopia from 1975 to 1993. Twenty-two of these were analysed for clinical features, etiologic diagnosis and results of treatment Most patients were young adults with male preponderance. Clinical features coincided with findings in other series of constrictive pericarditis and intractable pericardial effusion. The operative findings at pericardiectomy was a thickened pericardium in, all cases, which was adherent to the heart in the majority of cases, and with a large pericardial effusion in four cases. Histology confirmed the presence of tuberculosis in the pericardium in six cases and in the other cases it showed nonspecific chronic inflammation. Sixteen patients were discharged improved and six died after surgery.