Abstractobjective To determine mortality and retention in ART programmes in Tanzania, between 2010 and 2013.methods Retrospective routinely collected data were analysed from people starting ART in the period 2010-2013. Mortality and retention over the first 12 months on ART were compared across the 4 years, and adjustment was made for individual level potential confounders. conclusion Mortality and retention in the first 12 months on ART have significantly improved over the 4 years from 2010 to 2013. These improvements may indicate better services, earlier initiation on ART, and strengthened systems to provide ART in Tanzania. These results refute the worries that earlier initiation on ART might lead to lower retention in the ART programme.