BACKGROUND Metabolic encephalopathy (ME) is one of the most frequently encountered and broadly defined diagnoses by the physicians in the intensive care setting. ME is a clinical state characterized by cerebral dysfunction in the absence of structural brain disease. The causes are many and often multifactorial. The purpose of study was to evaluate various causes, clinical profile, and outcome in patients with ME. METHODS This is a hospital based, observational, cross sectional study, conducted in ICU of Department of General medicine, S.N. Medical College, Bagalkot. Patients with head trauma, organic causes of altered sensorium, psychiatric conditions were excluded. RESULTS Mean age was 51.22 ± 17.24 years. Majority were males. Diabetes was the most common comorbidity found followed by cirrhosis of liver and hypertension. Septic causes were found to be the most common aetiology. 80.7 % recovered from the disease and death was noted in 19.3 % patients. CONCLUSIONS All the patients with ME had altered level of consciousness with fever being the most common symptom. Most of them were males, most common aetiology was septic cause, and recovery was seen in about 80.7 % of patients. KEYWORDS Metabolic Encephalopathy, Altered Sensorium, Sepsis