Abstract Background: Surgical problems in the HIV patient include not only abnormal presentation of common illnesses but also include unique problems that are consequences of the acquired immuno suppression. Aims: 1. To study the pattern of various surgical presentations of HIV patients. 2. To know the pattern of impact of effective ART on surgical presentations. Settings and Design: We conducted a cross sectional study on patients admitted in Surgery ward over 6 months time among the patients initiated on ART (Anti retroviral therapy) from a comprehensive HIV care centre to analyze the various conditions in HIV patients warranting surgical care and intervention. Materials and Methods: We collected data from March 2014 to August 2014 by personal interview with the HIV infected patients who attended General Surgery, other Surgical Specialties, Obstetrics & Gynecology and Casualty departments of Medical College, Thrissur. Their details about anti retroviral treatment were collected from ART clinic in the hospital and their data regarding various surgical interventions were collected from registers in respective departments. Results and Conclusion: We had 92 cases of surgical admissions during study period. 85 (92%) patients in this group had surgical interventions and 7 (8%) cases were managed conservatively. The conclusions of this study were effective ART increases the number of elective surgical problems in HIV patients due to their increased survival and it also shows the different types of surgical presentations in HIV patients.