Context: People living with HIV (PLHIV)/AIDS are faced with the task of maintaining optimal health status despite an increasing insult to their immune status. Antiretroviral therapy (ART) centers provide comprehensive services to all PLHIV enrolled under the program. Patients with higher satisfaction levels may also have improved health outcomes. Aim: The aim of this study was to assess the client's satisfaction on ART service delivery and to identify the factors associated with client's satisfaction. Settings and Design: This was a facility-based, cross-sectional study. Materials and Methods: The study was conducted from August to October 2018 at the ART center of Rajamahendravaram. A total of 485 HIV-positive clients above the age of 15 years on ART for >6 months were selected by systematic random sampling after taking informed verbal consent. Data were collected by interviewing with the help of a validated structured English-version Likert-scale questionnaire, that is, University of Gondar College of Medicine and Health Sciences Institute of Public Health Pro forma. Statistical Analysis Used: Binary logistic regression and Chi-square test were conducted to identify the association between the explanatory variables and outcome variables (patient satisfaction). Results: The mean age of the clients was 39.6 ± 9.9 years. The overall satisfaction rate among the clients was 92.6%. Age, marital status, education, family income, socioeconomic status, and the waiting period to see the doctor were statistically significantly associated with the level of satisfaction of the clients ( P < 0.05). Conclusion: The present study shows high levels (92.6%) of client satisfaction with services provided at the ART center, Rajamahendravaram. This motivates the health-care workers, program planners, and policymakers for a better continuum of care.