Tuberculosis is a serious health threat, especially for people living with HIV. people living with HIV are more likely than others to become sick with TB. Worldwide TB is one of the leading courses of death among people living with HIV (CDC 2015). A retrospective cohort study was conducted in which all patients registered for TB/HIV at Rashid shekoni teaching hospital from 1st January 2017 to 31st December 2021. Kaplan Meier and log rank test were used to determine the survival pattern and the survival experience of two or more different groups. Cox regression was used to identify factors affecting the survival time of the patients. This study consists of 274 TB and HIV co-infected adult patient out of these 120 were died during the study period, and 154 were censored.it was found that massive death occurred at 1.3years of follow up period and the over roll median survival time was (56 months). the multivariate cox regression analysis indicated that an old age patient>39yrs, HIV+, low CD4 cell count<456, weight<42 were significant risk factors associated with death of TB/HIV co-infected patients. In this study the death of TB/HIV adult co-infection was found to be very high at 1.3yr. The risk factors leading to early death of TB/HIV co-infection was associated with age, weight, HIV+ positive, CD4 cell count. The medical decision and policy makers should give these risk factors identified in this study more priority when implementing target improvement in the National TB and HIV program.