Background: TB/HIV co-infection poses a great impact to public health. TB is the mostrncommon opportunistic infection and the most common cause of mortality in HIV infectedrnchildren around the globe. But there is scarceness of studies concerning the predictors ofrnmortality among TB-HIV co-infected children. rnObjective: To assess the survival and predictors of mortality among TB-HIV co-infectedrnchildren attending ART clinics of public hospitals in SNNPR, Ethiopia from 2009-2019. rn Methods: Hospital-based retrospective cohort study was employed from January 1rn, 2009 tornDecember 31rnstrn2019 among 284 TB-HIV co-infected children attending ART clinics of selectedrnpublic hospitals in SNNPR, Ethiopia. Then, medical records were reviewed using a structuredrndata extraction tool. Data were entered using Epidata 4.6 and analyzed using SPSS version 23.rnThe Kaplan Meier survival curve along with log rank tests was used to estimate and comparernsurvival time. Bi variable and multivariable Cox regression were conducted to identify predictorsrnof mortality among TB/HIV co-infected children. Adjusted Hazard Ratio with its 95%rnconfidence interval was used to estimate the strength of association and P-value â‰¤ 0.05 wasrnconsidered as statistically significant. rnResult: A total of 284 TB/HIV co-infected children were included in the study. Among these, 35rn(12.3%) of them died during the study period. The overall mortality rate was 2.78 (95%CI= 1.983.99)rnrnper 100 child years of observation. The independent predictors of mortality were anemiarn(AHR=3.6; 95%CI: 1.39-9.31), fair or poor ART drug adherence (AHR=2.9; 95%CI=1.15-7.43),rnextra pulmonary TB (AHR=3.9; 95%CI: 1.34-11.45) and TB drug resistance (AHR=5.7; 95%CI:rn2.07-15.96). rnConclusion: Mortality rate of TB/HIV co-infected children in selected public hospitals inrnSNNPR, Ethiopia was high. Moreover, anemia, drug resistant tuberculosis, extra pulmonary TBrnand poor adherence to ART drugs were identified as the predictors of mortality among thesernchildren. rnst