Abstract: Objective To evaluate the effectiveness of free highly active anti-retroviral therapy (HAART) for adult HIV/AIDS patients from 2004 to 2014 in Shanghai and to identify predictive factors that may influence HAART. Methods A retrospective analysis was made on 3 939 cases of HIV infected people and patients from the information system for the prevention and control of AIDS, who received HAART in 2004-2014 in Shanghai. Results Among 3 939 patients, 90.2% were males, and the mean age was 38.4±12.5 years. EFV+3TC+AZT was the most common regimen (35.8%). The mean CD₄⁺ T cell count was (199.2±142.9)/mm³ at baseline while(457.2±211.9)/mm³ after HARRT. Significant difference was found in CD₄⁺ T cell count between those at baseline and after HARRT, and with the group of females, there was longer treatment period, heterosexual transmission and baseline CD₄⁺ T cell count lower than 350 cells/mm³ with greater growth of CD₄⁺ T cell count. After HARRT, HIV viral loads in 93.5% patients were below the detection limit. Non-conditional logistic regression analysis indicated that the length of treatment period affected the virological response of HAART. The longer the patient received HARRT, the greater virus inhibition effect they had. Conclusion From 2004 to 2014, the antiretroviral therapy for HIV/AIDS patients in Shanghai was obviously effective.