In sub Saharan Africa peripheral lymphadenopathy is the common clinical presentation in patients with HIV/AIDS presenting in care and treatment clinics at any stage of the disease. Little is known on the clinical and pathological pattern of peripheral lymphadenopathy in this population leading to inadequate management of these, resulting in poor patient outcome. METHODS AND RESULTS. In duration of six months (October 2014 to March 2015) a cross sectional study was done to describe the clinical and pathological pattern of peripheral lymphadenopathy in patients with HIV/AIDS attended in Care and Treatment clinic at KCMC, a special referral hospital in northern zone of Tanzania. Sixty patients were recruited in the study, who underwent clinical examination, and their HIV/AIDS clinical staging, including their CD4 T lymphocyte count were reported from their CTC2 Card if it was done in six months. In case this was not done, clinical staging was done and blood samples were taken for CD4 T lymphacyte count. All patients underwent thorough clinical history of their disease and excisional/incisional biopsy of the lymph node of interest was taken. Lymph node tisues were stored in 10% buffered formalin, fixed in paraffin wax blocks, dewaxed, stained in haematoxylin and in 1% Eosin and mounted under the cover slip with DPX and read by an experienced pathologist. Out of 60 patients, reactive lymphadenopathy 22(36.7%) was the most common histological daignosis followed by malignancy 17(28.3%), tuberculosis 15(25%) and 6(10%) were inconclusive. The common clinical presentation was weight loss 52(86.7%), followed by night sweats 50(83.3%), fever 46(76.7%) and cough 36(60.0%). The common site for the lymph node was cervical 38(63.3%) and majority of patients 58(96.7%) were in WHO clinical stage IV. CONCLUSION Clinical presentation of peripheral lymphadenoapthy in patients with HIV/AIDS is not uncommon at KCMC CTC, and histologically it has been shown to be reactive, malignancy or tuberculosis. All patients with HIV/AIDS should have a thorough clinical examination and undergo or referred for lymph node biopsy for a definitive diagnosis to improve patients outcome. However there is a need of a multcentre study to describe the clinical and pathological pattern of peripheral lymphadenopathy since these results may not be generalized.