The human immunodeficiency virus is a human T-cell lymphotropic retrovirus of the lentivirus subgrouprnthat induces immune-suppression and causes the acquired immunodeficiency syndrome (AIDS). Antiretroviralrntherapy (ART) has definitely decreased mortality and increased the quality of life of affectedrnindividuals but using highly active anti-retroviral therapy (HAART) containing especially proteaserninhibitors (PIs) in HIV infection management has led to increased prevalence of cardiometabolicrnsyndrome (CMS). Although several studies on CMS in HIV-positive patients on HAART, and the risk ofrncardiovascular disease (CVD) has been conducted in many countries, there are few researches especiallyrnon PIs conducted in Ethiopia. Therefore, the aim of this study was to narrow this gap and determine thernmagnitude of CMS components including hypertension, dyslipidemia and diabetes to identify the risk ofrnCVD among HIV-positive patients on HAART. Hospital based prospective cohort study was conductedrnat Zewditu Memorial Hospital between March 2018 to December 2018. The source population includedrnall HIV patients who were on chronic HAART follow up. All HIV patients that met the inclusion criteriarnwere recruited over a four-month period. Socio-demographic, medical history, behavioral and dietaryrnexposures were obtained from patient self-report data using a structured questionnaire. The data werernentered and processed using SPSS version 23 statistical software. Ethical clearance was obtained fromrnInstitutional Review Board of the College of Health Sciences, Addis Ababa University and Addis AbabarnHealth Bureau. One hundred forty patients, 52 males (37.1%) and 88 females (62.9%) were included inrnthe study. Using Adult Treatment Pannel III criteria 59 patients (42.1%) were diagnosed for the presencernof CMS. The prevalence of hypertension, hypertriglyceridemia, impaired fasting glucose (IFG) andrnabnormal waist circumference were 50.0%, 65.7%, 67.1% and 47.1%, respectively. In multivariaternanalysis, having abnormal BMI, i.e., over weight (AOR: 4.87, CI: 1.49-15.69) and total cholesterol â‰¥ 200rnmg/dl (AOR: 3.67, CI: 1.17-11.49) were independently associated with CMS. High prevalence of CMSrn(42.1%) among HIV infected patients receiving PIs was observed. Prevalence in CMS components wasrnalso higher, IFG being the most prevalent one.