Abstract:Background: HIV/AIDS and malnutrition effects are interrelated and exacerbate one another in a vicious cycle.HIV specifically affects nutritional status by increasing energy requirements, reducing food intake, and adversely affecting nutrient absorption and metabolism. In Ethiopia since its detection, has claimed lives of millions. Even in the era of ART, it could not be tackled since the dispute of malnutrition is unanswered. Therefore the study aimed to assess nutritional status and associated risk factors among adult HIV/AIDS clients in Bahir Dar, Ethiopia. Method: was facility based cross sectional survey in Felege Hiwot referral Hospital. On average 50-60 Pre-ART and/or on ART care clients were visiting the Hospital daily. Taking the first patient as case one, every 4 th of daily attendances were interviewed using interviewer administered questionnaire and anthropometric measurements. SPSS version 16 statistical software was used to enter and analyze the data. Binary logistic regression was used to assess effect of factors on HIV/AIDS clients' nutritional status. P value ≤0.05 was considered statistical significant. Results: 408 HIV/AIDS clients were interviewed, of them 104 (25.5%) were chronic energy deficient (BMI<18.5kg/m2); 36.5% from pre-ART, 63.5% from on ART care. Proportion of mildly, moderately, and severely malnourished participants were 64.4%, 19.2%, and 16.4% respectively. Females were most affected (56.7%). HIV/AIDS related symptoms 2weeks prior to the survey (AOR=1.93, 95% CL: 1.18-10.0); eating difficulty (AOR=1.80, 95% CL: 1.10-2.04); Pre ART clients (AOR=1.77, 95% CL: 1.08-2.90); and on ARV drugs < 12months (AOR=1.7, 95% CL: 1.04-3.78) were the predictors associated to malnutrition. Conclusions: Chronic energy deficiency was prevalent in PLWHA. HIV related symptoms, feeding difficulties and duration on ART were the predictors for malnutrition. Only increasing access to ART can't solve problem of malnutrition, therefore nutrition therapy and support as an adjunct to the initiation of ART should be considered.