OBJECTIVES: Globally, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) reduces life expectancy by several years. Mortality is high among non-treated patients. However, the predictors of mortality have not been adequately studied. Hence, the main objective of the study was to determine predictors of mortality among HIV positive adults who are not on antiretroviral treatment, in a South Indian hospital. METHODS: A facility-based retrospective cohort study was conducted and data were collected from 150 patients who were registered but not on treatment from December 2011 to December 2013. Multiple logistic regression analysis was applied to identify the risk factors for mortality among HIV patients.  RESULTS: A total of 40 patients were died during the follow-up period. Patients with age between 39-59 years (OR 0.49, 95% CI 0.28-0.84), baseline World Health Organization (WHO) staging III and IV (OR 0.09, 95% CI 0.04-0.20 and OR 0.11, 95% CI 0.04-0.27), patients with opportunistic infections (OR 4.93, 95% CI 2.87-8.84), were found to have less risk for mortality compared to their counterparts. Patients with low BMI (OR 2.05, 95% CI 1.21-3.49), CD4 count >200 cells/µl (OR 3.88, 95% CI 2.27-6.65) were found to have more risk.  CONCLUSIONS: Age group 18-38, patients without opportunistic infections, baseline WHO staging stage I and II, low BMI, CD4 >200 cells/µl were all significant predictors of mortality. Therefore, patients with the aforementioned predictors should be followed closely and frequently.