Background: Non-traumatic coma is a medical emergency with diverse etiologies and significant morbidity and mortality. Understanding the causes and outcomes of non-traumatic coma in a tertiary care setting is crucial for improving management strategies. Objective: This study aims to analyze the etiological factors and outcomes of non-traumatic coma patients admitted to a tertiary care hospital. Methods: A prospective observational study was conducted on non-traumatic coma patients admitted to the intensive care unit of a tertiary care hospital over a period of one year. Clinical presentation, laboratory investigations, neuroimaging findings, and outcomes were recorded. The Glasgow Coma Scale (GCS) was used for initial assessment. The outcomes were categorized as recovery, persistent vegetative state, or mortality. Results: A total of 200 patients were included in the study. The most common etiologies identified were metabolic disorders (35%), central nervous system (CNS) infections (25%), cerebrovascular diseases (20%), poisoning (10%), and others (10%). The mortality rate was 40%, while 45% of patients showed significant recovery, and 15% remained in a persistent vegetative state. The GCS at admission was a strong predictor of outcome (p<0.05). Conclusion: Metabolic disorders and CNS infections were the leading causes of non-traumatic coma. Early diagnosis and prompt intervention could improve patient outcomes. Further studies are needed to refine management protocols in such cases.