Introduction:Though being truly empathic with the patient in health service provision is challenging, it is a powerful and efficient communication tool when used appropriately. It is valuable for healthcare providers and receivers if patients perceived the healthcare providers understand the values, ideas and feelings of their patients. Therefore, this study was carried out to measure the level of perceived healthcare provider empathy and its’ determinants among outpatients of public and private hospitals in Addis Ababa, central Ethiopia.Material and Methods: Data were collected as part of a comparative cross sectional study conducted during March 27 to April 30/2010 in Addis Ababa. The size of the sample was determined using double population proportion formula. The study participants wereoutpatients who were identified using systematic sampling technique at randomly selected private and public hospitals. The data were collected using a structured questionnaire with Likert scales to measure perception of patients. Data were entered into computer software (SPSS version 16.0) to generate descriptive statistics and factor scores. ANOVA and multiple linear regression analysis were conducted.Result: The respondents of the study were 626 (313 for each group of the hospitals) with response rate of 93.71%.The mean (± S.D) levels of perceived empathy at public and private hospitals were 33.47 (± 11.654) and 38.16 (± 10.161), respectively with possible value range of 10 to 50. At public hospitals, Welcoming approach, body signaling, consultation duration, perceived providers’ technical competency, perceived providers lack of experience and ability and expectation about the hospital services were appeared significant determinants of perceived empathy level. Likewise, perceived welcoming approach, body signaling, perceived providers technical competency, perceived providers lack of experience and ability, waiting time, perceived accessibility, expectation about hospital services and perceived cleanliness predicted perceived empathy at private hospitals.Conclusion: Despite significant difference in the level of perceived empathy at public and private hospitals, four of the identified determinants were common.The predictors of perceived provider empathy in this study were related to characteristics of patients, health care providers and the health system. Therefore, health service managers and health care providers should work on improving the communication skills of health professionals which could significantly alter the perception of the patient to services s/he receives at the outpatient department.