Abstract: Objective To investigate the survival rate, virological and immunological outcome of HIV-positive men who have sex with men (MSM) under antiretroviral therapy (ART) in Suzhou City. Methods A retrospective analysis was conducted on HIV-positive MSM receiving ART between 2005 and 2014. Results A total of 735 MSM, with an average age of 36.5, received ART in Suzhou. The cumulative survival rates at 12, 24, 36 and 48 months after therapy were 0.99, 0.97, 0.97 and 0.97, respectively. After ART, CD4 cell counts increased with an average of 161 cells/mm³, and 88.0% maintained immune responses. Those receiving therapy less than 12 months (OR:0.30,95%CI:0.16, 0.55), within 13-24 months (OR:0.43,95%CI:0.23,0.84) were less likely to achieve immune recovery than those above 24 months of therapy. And 86.8% of the total achieved an undetectable viral load after ART. Those receiving ART less than 12 months (OR:0.31,95%CI:0.14, 0.66), within 13-24 months (OR:0.39,95%CI:0.21,0.74) were less likely to achieve viral suppression. Conclusion ART in HIV-positive MSM is largely effective in prolonging lives, suppressing viral load and immune reconstitution. Efforts should be made to manage and monitor subjects receiving ART within 24 months.