Background: HIV continues to have a major impact on public health globally with anrnestimated 36.9 million people living with HIV (PLHIV) including 1.8 million newrninfections in 2017.As 2017 national guidelines for comprehensive HIV prevention, carernand treatment of Ethiopia, all people living with HIV are eligible for ART irrespective ofrntheir CD4 count and clinical stage. Little is known about the viral load suppression ofrnclients who initiate ART irrespective of their CD4 count and clinical stage in Addis Ababa.rnThe aim of this study is to assess the viral load suppression of rapid ART initiation of rnconfirmed HIV positive clientâ€™s and factors associated with their outcome.rnObjectives: To assess the viral load suppression of rapidly initiated ART clients comparedrnwith not rapid ART initiated clients and its associated factors at public health facilities ofrnKirkos s/city, Addis Ababa, Ethiopia in 2021. rnMethods: A retrospective cohort study was conducted among 356 HIV/AIDS positivernpatients selected from nine public health facilities of kirkos sub-city in Addis City fromrnJuly to August /2020. The main exposure variable is Rapid ART initiation and the mainrnoutcome variable is the viral load suppression. The data were entered and cleaned usingrnEPI data version 3.1 and analyzed with SPSS version 25. Bivariate and multivariablernlogistic regression analyses were employed to know the factors that affect the viral loadrnsuppression of clients who start ART by their category. rnResult: This study Clients who start ART rapidly were 4.5 times more likely to have viralrnload suppression when compared with not rapid ART started clients with p-value rn0.008[AOR 4.46 (95% CI= (1.48-13.42)].Clients who have primary education were almostrn13 times [AOR = 12.88, (95% CI= 2.90-57.12)] more likely to have viral load suppressionrncompared with clients who do not educated. Clients who have poor drug adherence werernless likely to have viral load suppression with p-value of