Abstract: Missing regular appointments to ART centres in Srikakulam have increased by over 5% in the last one years. In 2015, between January to June, with the help of staff of ARTC, RIMS GH, Srikakulam, we conducted a retrospective cohort study in srikakulam district of Andhra Pradesh. PLHIV of age group 15-74, and regular on treatment at srikakulam by the end of DEC 2014 were considered for study at 50:50 gender ratio. In the study, a total of 1258 new missed appointments were found out of 22800 scheduled appointments. The most frequently reported drug regimen in missed appointments were TDF+3TC+EFV (TLE) (752 episodes), ZDV+3TC+NVP (ZLN) (442 episodes) and ZDV+3TC+EFV (ZLE) (56 episodes), and 24-44 age group has a share of 70% new miss. So, we recommend a thorough relook into national guidelines for implementation of TLE as single drug, owing to its high rate of missing appointments in productive age group (25-44 years) as it may hamper the national program and a further study recommended for cause of rejection of regimen in PLHIV is much needed.