Introduction: Malnutrition is a common complication among HIV-infected children. HIV impairs the immune system, making the body vulnerable to various infections. Infections leads to malnutrition which further contributes to a weakened immune system making a vicious cycle. This leads to a rapid progression to AIDS. Objectives: To assess the burden of malnutrition and to know its effect on immune status of HIV infected children attending Anti-Retro viral Therapy (ART) Centre. Methodology: The study was conducted among HIV positive children aged 0-14 years, attending ART Centre of Belagavi Institute of Medical Sciences (BIMS) Hospital, Belagavi. Anthropometric measurements and CD4 counts were recorded. Anthropometric indicators were expressed in Z-scores. Three types of malnutrition were defined: acute malnutrition (WHZ/BAZ __ampersandsignlt; -2 SD and HAZ __ampersandsignge; -2SD), chronic malnutrition (HAZ __ampersandsignlt; -2 SD and WHZ/BAZ __ampersandsignge; -2 SD) and mixed malnutrition (WHZ/BAZ __ampersandsignlt; -2 SD and HAZ __ampersandsignlt; -2SD). Results: The study included 180 HIV infected children (112 boys, 68 girls). The prevalence of malnutrition was 78.3%. Acute, chronic and mixed malnutrition was seen in 17 (9.4%), 106 (58.9%), 18 (10.0%) of the study participants respectively. Immunodeficiency was seen in 42% of them. The presence of malnutrition in the study participants was significantly associated with immunodeficiency. Conclusion: There was high prevalence of malnutrition among the HIV infected children. HIV acts as an independent risk factor for malnutrition. Malnutrition should be treated and prevented to ensure optimal response to ART and reduce early mortality.