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Introduction: The prevalence of HIV and AIDS continues to grow worldwide. Urological manifestations of HIV and AIDS such as urolithiasis, obstructive uropathy, complicated UTI and malignancy are often first clinical signs. With the availability of antiretroviral drugs and surgical intervention, the prognosis of HIV-infected patients is same as that of general population. Aim: To evaluate incidence of urological manifestations, their treatment and outcome in HIV and AIDS patients. Material and Methods: This was retrospective study conducted at Institute of Nephro-Urology, Bengaluru from June 2011 to May 2016. Inclusion criteria were all HIV and AIDS patients suffering from urological diseases. The data were collected in a Microsoft® Excel database and analysed through SPSS 20 version. Results: A total of 161 patients (male -93, female-68) with HIV and AIDS were analysed retrospectively. The most common presentations were Urosepsis (31.05%), Urolithiasis (27.32%), Malignancy (16.77%), Renal dysfunction (11.18%), Stricture urethra (7.45%), GUTB (Genito-Urinary Tuberculosis) (3.10%) and others (2.4%). The most common surgical intervention done was DJ stenting. Renal abscess, psoas abscess and stricture urethra patients underwent surgical intervention. Uncomplicated UTI was treated conservatively. Sepsis and pyogenic infections were more common in patients with CD4 count <200 cells/mm3. Out come was compared with non HIV-AIDS patients. Conclusion: Complicated UTI followed by calculus disease were most common in our study. It is important to create awareness of the urologic manifestations of HIV and AIDS among the retroviral positive patients. [ABSTRACT FROM AUTHOR]