BACKGROUND India has a high adult HIV prevalence rate (0.26%). In the Highly Active Anti Retro Viral Therapy (HAART) era, there is increased lifespan of HIV patients which confers a higher lifetime risk of developing cancer. The estimated prevalence of HIV infection in the age group 15-49 years in India is 0.26% according to the 2015 NACO (National AIDS Control Organisation) report. Patients with HIV infection are prone to develop malignancies, especially viral mediated cancers like Kaposi sarcoma (related to HHV-8), invasive cervical cancers (HPV related) and aggressive B cell lymphomas (often EBV related) due to the loss of immune surveillance. Cancers are an important cause of morbidity and mortality in patients with HIV infection accounting for nearly 36% of the deaths in PLWHA (People Living with HIV-AIDS). METHODS A retrospective analysis of the patients with HIV and cancer registered in the Department of Medical Oncology, during January 2014 to June 2018 was done using baseline patient factors, pathology reports and treatment details. The survival analysis was done using IBM SPSS software (v-21). RESULTS The study included 44 patients with HIV and cancer, all of whom were on antiretroviral therapy. The mean time to presentation of cancer after diagnosis of AIDS was 5.4 years. Non-AIDS Defining Cancers (NADC) were present in 72.7% of patients. The most common malignancy was Non-Hodgkin`s lymphoma (31.8%), plasmablastic lymphoma being the most common subtype. Extranodal presentations (78%) were more common. B symptoms were present in 57% of cases. Head & neck, penile, anal, cervical and colorectal cancers were the common solid tumours. Majority of the NHL patients presented with stage 1 disease, while most solid tumours were in advanced stages. Among the 14 NHL patients, 7 received chemotherapy and had a median survival of 6 months. Chemotherapy regimens included CHOP, CVP, R-CHOP and R-CHOP-E. Treatment schedule was completed in 4 patients with 2 achieving partial response. 46.6% of HIV patients with solid tumours received chemotherapy with 5 achieving partial response (PR) and 1 achieving complete response (CR). They had a median survival of 7 months as compared to 2 months in those who received only supportive care. CONCLUSIONS In the HAART era, NADCs are more common than ADCs. The most common malignancy in HIV patients in this study is NHL, with plasmablastic subtype being the commonest. In the HIV associated lymphoma patients, chemotherapy provides a response rate of 50 % and achieves a median survival of 6 months as compared to only 1.5 months in those treated with supportive care. Standard chemotherapy in HIV patients with solid cancers achieve a response rate of 46%.