BackgroundBurden of HIV/AIDS is high in low- and middle-income countries including Ethiopia. In resource-poor countries like Ethiopia, the survival of patients with AIDS treated with ART depends on a variety of factors, which may also vary greatly with economic, demographic, behavioral risk, and health factors. Unlike other previous studies, this study was done at health centers since some of the clinical factors may differently affect the survival of the patients under ART. ObjectivesThe main aim of this study is to estimate the mortality rate and survival predictors among adult HIV infected patients under ART at health centers in Kirkos sub city.MethodA retrospective cohort study was conducted at the health centers found in Kirkos sub-city, Addis Ababa. All adult HIV positive patients under follow-up between Dec. 1, 2014, and Oct. 30, 2019 were the source population. A total of 665 samples were taken using the lottery method. Data were extracted from the patient card and electronic database by trained data collectors. Kaplan-Meier and Cox-proportional hazard regressions were used. Resulta total of 55(8.5%) of death has occurred with the incidence death of 3.25/100 person-years. Majority of deaths occurring within 6 months of ART initiation. Predictors mortality were patients with age category above 50 years (AHR = 4.90, 95% CI: 2.00, 11.98), TB comorbidity (AHR= 3.46, 95% CI: 1.52,7.91), WHO stage IV (AHR = 4.55,95% CI: 1.72,12.02), lack of dug adherence (AHR=1.76, 95% CI: 1.23, 3.33), co-trimoxazole therapy (AHR=2.56, 95% CI: 1.25,5.24),BMI of less than 18.5 (AHR= 2.59, 95% CI: 1.37,4.90) and CD4 cell count, below 200/dl (AHR =22.77, 95% CI: 1.30,5.92).ConclusionThe majority of deaths occurring within six months of ART initiation. Factors directly or indirectly affects immunity were associated with poor survival. Prevention of TB infection, enhancing feeding and early screening of nutritional status of patients’ needs great attention.