Background information: In contrast to, many initiatives implemented to tackle Tuberculosis, manyrncountries have not so far reached the targets set by WHO. The main reason mentioned so far was thernimpact of HIV infection. Therefore, it is essential to determine the impact of HIV/AIDs on the clinicalrnpresentation and treatment outcome of tuberculosis locally.rnObjectives: To compare clinical presentation, treatment outcome of TB and on treatment survivalrnamong HIV positive and negative TB patients who are through (DOTs).rnMethods: A retrospective cohort study design was employed to compare the clinical presentation of TBrnand its respective treatment outcome between the exposed; HIV positive (n=370) and non exposed; HIVrnnegative TB patients (n=370) who were through the short course DOTs in Hawassa Health Center fromrn2006-2010. Patientâ€™s HIV status during the diagnosis of TB or initiation of DOTs was considered as anrnexposure and TB treatment outcome was considered as the outcome variables. Standard WHO definition,rnis used to classify tuberculosis cases and TB treatment outcomes.rnResults: Smear negative PTB was significantly the frequent presentation, 0.32, 95%CI (0.25, 0.39;rnZ=8.76, P=0.000) among HIV positive study subjects, while significant difference in proportion of smearrnpositive PTB; (-0.26; 95%CI (-0.33 -0.19; Z=-6.25, P=0.000) was in favor of HIV negative individuals.rnCompared to HIV negative TB patients ,cure rate was substantially lower in HIV positive TB patientsrn(73% vs. 87.9%, z=-2.5, P=0.04), and the risk of death was statistically higher among TB/HIV co infectedrnpatients; AHR=1.6, 95%CI(1.01-2.6) during the course of DOTs. Regarding survival of TB patients, thernsurvival probability was lower for HIV/TB co infected patients (Log rank test= 6.90, df= 2,P=rn0.008).When adjusted for covariates, the survival probability is below 15% for HIV positive but abovern85% in HIV negative TB patients at the end of DOTs period(8th month). The independent predictors ofrndeath, while on treatment are age, weight and HIV infection.rnConclusion: On TB treatment survival probability and cure rate are substantially lower in HIV infectedrnTB patients due to an increased death and unfavorable treatment out comes for the former and the laterrnrespectively. Therefore targeted and comprehensive management of TB should be considered in thisrngroup of patients.rnKey words: Clinical presentation, treatment outcome, survival of TB patients, Hawassa health center