Background: HIV/AIDS is one of the most destructive diseases mankind has ever faced. Itrnbrings with it profound social, economic and public health consequences. It has become one ofrnthe worldâ€™s most serious health and development challenges. The aim of this study was to definernthe profile of attendances of HIV positive patients who presented to Emergency department. rnMethod: Cross sectional study was employed on adult PLHIV visiting emergency departmentrn(ED) at tertiary hospital in Ethiopia from February 1 to April 30 2019. Data analysis wasrnperformed by SPSS version 25 software. Descriptive statistics and Chi-square were utilized. rnResult: There were a total of 87 patients. The mean age is 38.21(Â±10.5) years majority of themrnare between the age of 35 and 44 years. and male to female ratio almost 1:1. 10.3% were newlyrndiagnosed. 50.6% had comorbidities. Only 79.3% were taking HAART, and 58.6% were WHOrnclinical Stage IV. 57.7% had visited ED for HIV infection related problems and TB CNSrntoxoplasmosis and esophageal candidiasis are the most common opportunistic infections. Therernis significant association between blood pressure and death; sex and occupation with advancedrnstage of the disease. rnConclusion: The findings revealed that middle age groups are at high risk reflecting importantrneconomic and social impacts. As a third of the PLHIV visited ED for HIV non related issues tornfacilitate early HIV diagnosis and early initiation of HAART, all stakeholders in the regionrnfacilitate HIV testing. More attention should be given for middle age group of PLHIV. HIVrnguideline should include treatment of associated comorbidities.