Background: Respiratory failure is disturbance of respiratory system in O2 and CO2 gas exchange and remains a problem in medical treatment. Further description of relationship between underlying disease of respiratory failure with the treatment’s outcome is required. Objective: To describe whether there is a relationship between underlying disease of respiratory failure with the treatment’s outcome on hopitalized patient in Dr. Moewardi general hospital Surakarta. Method: This is a cross sectional study on 77 patients with respiratory failure in 2009, using their medical records. Result: Data from 77 patients with respiratory failure treated in pulmonology department consists of: 52 male (67,53%), 25 female (32,47%). Most of their age goups ranged from 61-80 years old in 34 patients (44,15%) with their main chief complaint is shortness of breath in 68 patients (88,31%). The most common underlying disease is COPD in 37 patients (35,58%). Patients with respiratory failure without concomitant diseases (comorbidity) are 36 patients (46,76%). The result of blood gas analysis revealed respiratory acidosis not compensated in most of the patient, as much as 29 patients (37,66%) and type II of respiratory failure in 64 patients (83,12%). 59 (76,62%) patients were treated in the ward and 18 (23,38%) patients were treated in intensive care unit. Non invasive treatment was applied on 60 patients (77,92%) and invasive treatment was applied on 17 patients (22,08%). By the time the patients were discharged from the hospital, 52 patients (67,53%) recovered and 25 (32,47%) patients didn’t recover (home forcibly and died). There is a significant correlation between underlying disease of respiratory failure with the treatment’s outcome, where the value of p = 0,002 (<0,05). Conclusion: There is a relationship between underlying disease of respiratory failure with treatment’s outcome. Key words: Respiratory failure - underlying disease - treatment - outcome.