This is a retrospective study on a cohort of 811 adult patients placed on ART between January 2004 and December 2011 at the hospital Nianankoro Fomba Segou in Mali, to describe their epidemiological, clinical and developmental profile for 48 months. The average age of patients was 35.2±9.4 years. The sex-ratio was 0.6. Approximately 58.3% of the patients were from rural areas. HIV1 represented 95.8%. Prolonged fever, weight loss and chronic diarrhea were the main reasons for testing. The majority of patients (64.5%) had stage III WHO. The mean CD4 cell count was 144±135.8/mm³ at screening. The evolution was favorable under immunological antiretroviral therapy. The survival rate at 48 months follow-up was 78% [64.1%-81.3%]. Patients followed in the structure are predominantly rural, female and young aged. They are diagnosed with advanced HIV infection. Antiretroviral therapy has led to the strengthening of the immune system and improved the clinical outcomes with a survival rate of 78%.