In Libya, little is known about HIV-related hospitalizations and in-hospital mortality. This was a retrospective analysis of HIV-related hospitalizations at Tripoli Medical Centre in 2013. Of 227 cases analysed, 82.4% were males who were significantly older (40.0 versus 36.5 years), reported injection drug use (58.3% versus 0%) and were hepatitis C virus co-infected (65.8% versus 0%) compared with females. Severe immunosuppression was prevalent (median CD4 count = 42 cell/µL). Candidiasis was the most common diagnosis (26.0%); Pneumocystis pneumonia was the most common respiratory disease (8.8%), while cerebral toxoplasmosis was diagnosed in 8.4% of patients. Current HAART use was independently associated with low risk of in-hospital mortality (OR 0.33), while central nervous system symptoms (OR 4.12), sepsis (OR 6.98) and low total lymphocyte counts (OR 3.60) were associated with increased risk. In this study, late presentation with severe immunosuppression was common, and was associated with significant in-hospital mortality. . Le diagnostic le plus fréquent était la candidose (26,0 %) ; la pneumonie à Pneumocystis était la maladie respiratoire la plus fréquente (8,8 %), tandis que la toxoplasmose cérébrale était diagnostiquée chez 8,4 % des patients). Un traitement antirétroviral hautement actif en cours était indépendamment associé à un faible risque de mortalité en milieu hospitalier (OR 0,33), tandis que les symptômes du système nerveux central (OR 4,12), la septicémie (OR 6,98) et les faibles numérations lymphocytaires totales (OR 3,60) étaient associés à un risque accru. Dans cette étude, une présentation tardive accompagnée d'une immunosuppression sévère était fréquente, et était associée à une mortalité élevée en milieu hospitalier.