Abstract: Objective To explore survival time and it's influencing factors among people with HIV/AIDS whether needing or having accepted highly active antiretroviral therapy (HAART) or not. Methods A retrospective cohort study was adopted. The subjects were obtained from Chinese national HIV/AIDS comprehensive control and prevention information system, presently living in Guangdong Province from January 2004 to June 2014, excluding less than 15 years old,Hong Kong, Macao, Taiwan, and foreign nationality. Survival curves of four groups were measured by productive-limit method. The difference of survival curves among all the groups were tested by log-rank. The risk factors affecting survival time of people with HIV/AIDS were analyzed by Cox proportional hazard model. Results A total of 28 474 cases were entered for analysis from 36 500 cases of HIV/AIDS who met the conditions. The sex ratio of male and female was 3.54∶1. They were mainly at 15 -39 years of age (68.78%). The marital status was mainly married (44.02%) and the route of transmission was mainly heterosexual (55.33%). Among them, 71.68% needed HAART and 53.50% had accepted it. The eight-year survive rates from high to low were 88.68%, 79.07%, 70.14%, and 42.92% for the four groups of Not-need-but-treated, Need-and-treated, Not-need-and-not-treated, and Need-but-not-treated, respectively (P< 0.01). In the Cox proportional hazard model, the risk of death was 1.42 times in males compared with females, increased 0.60 time for every 10 years of age in the cases aged above 15 years, 5.66 times in heterosexual transmission compared with homosexual transmission, and 9.60 times in transmission by drug injection compared with homosexual transmission. Compared with the group of ＜200 counts/mm3 in the initial test of CD4+T cells, the risk of death was decreased from 0.43 gradually to 0.26 time in the groups of ≥200 counts/mm3. Conclusion HAART can extend the survival time of people living with HIV/AIDS. The test of CD4+T cell counts should be conducted as soon as possible to confirm the course and provide the information for initiating HAART.