Introduction: HIV develops very rapidly among infants and children, and, without treatment, arnthird of children with HIV will die of AIDS before their first birthday, with half dying beforernthey are two. In 2009, there were 260,000 deaths attributed to HIV in under-15, most of whichrncould have been prevented through early diagnosis and effective treatment. Highly ActivernAntiretroviral Therapy has improved the survival of HIV infected patients. Low baseline CD4,rnlow weight for age, and high viral load levels were identified by studies as strong predictors ofrnmortality.rnObjective: To assess survival rate and predictors of survival among children on ART inrnHawassa Referral Hospital , Adare Hospital and Bushulo Health Center, Hawassa .rnMethodology: A retrospective cohort study was conducted among children on ART. A total ofrn222 patientâ€™s records enrolled between July 28, 2006 to September10, 2011 was reviewed.rnKalpan Meir survival analysis was used to estimate mean survival time and Life table was usedrnto estimate survival probability after introduction of ART and log rank test was be used torncompare Hazard curves. Cox proportional-hazard regression was used to calculate the bivariaternand adjusted hazard rate and then determine independent predictors of mortality.rnResults: A total of 222 children started on ART were followed for a median of 20 monthsrn(IQR=9-35.25). Among the cohort 119 (53.6%) were male the median age was 7(IQR=4-10).rnThe mean hemoglobin was 9.9 (SD, 4.22) and median CD4 count was 272.5 cells/Î¼lrn(IQR=164.75-446.25). The mean survival time of the entire cohort was 53.2 months (95% CIrn50.35-56.0). The independent determinants of mortality were WHO clinical sage IV AHR =9.64rn(95%CI 1.92-48.41) and low haemoglobin value(Hgb