HIV infection is a major public health problem as it has dramatically increased the global burden of disease. HIV infected patients experience a variety of clinical signs and symptoms. Our aim was to study the profile of clinical features and opportunistic infections in HIV in-fected adult subjects attending a tertiary care teaching hospital in north India. A total of 317 HIV infected patients attending the ART Centre and the ICTC of Chhatrapati Shahuji Ma-haraj Medical University, Lucknow were enrolled in the study, after obtaining informed consent. Clinical symptoms were recorded by direct questioning. Documented opportunistic infections were noted from patient records. 193/317 (60.9%) HIV positive patients were males and 124/317 (39.1%) females. Mean age of the patients was 34.2 ± 7.9 years. 271/317 (85.5%) patients were symptomatic. The common symptoms were weakness (65.6%), bod-yache and joint pain (63.4%), lethargy and fatigue (62.5%), prolonged fever (53.3%), weight loss (47.6%), cough (44.5%), loss of appetite (44.2%) and chronic diarrhoea (40.1%). The overall proportion of symptomatic patients was significantly higher than the number with an etiologically documented opportunistic infections (32.5%). Pulmonary tuberculosis (30.9%) was the most frequently documented opportunistic infection. Affordable high qual-ity laboratory diagnostic facilities for the diagnosis of opportunistic infections under the public health program will help to obtain an accurate picture of the range of opportunistic infections in HIV patients in India.