Presently there are 15 U.S. FDA approved antiretroviral agents available in India. The efficacy of the drugs is well decumented and various options available. The antiretroviral drugs act on various stages of replication of HIV in the body and interrupt the process of viral replication. Principally a combination of at least three agents.from different classes of antiretroviral drugs is the regimen of choice. Antiretroviral treatment regimen as approved by NACO is discussed in this article. In the case of treatment failure, second line regimen is being necessitated. Antiretroviral therapy initiative in India has already been taken with objectives, targets, National Paediatric HIV/AIDS initiative, etc.