Purpose : To identify disabilities and to determine their prevalence, age of onset and perceived cause in one urban and three rural areas in Northern Ethiopia. Method : A community based cross-sectional study of households that were selected by systematic sampling. Trained enumerators identified individuals with physical disabilities or epilepsy who were 5 years of age or older. Results : The overall prevalence of disability in 4214 individuals was 4.9%. The more common forms were walking difficulty (1.7%), loss of vision in one or both eyes (1.5%), hand dysfunction (0.8%) and epilepsy (0.7%). Information provided by the interviewees revealed a pattern of early onset, with injury and infection prominent as perceived causes. The importance of injury and infections was confirmed by the findings in half the people with disability, who were examined by a surgeon. Conclusions : Disability is a major public health problem and more facilities for rehabilitation and social support are needed. Measures that are needed to reduce the prevalence include health promotion, preventing injury, widening immunization coverage, better childhood nutrition and effective treatment for infection and injury. Further research should include younger children, cover a wider range of disability and use more sensitive means to detect hearing loss.