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This study was conducted in March 2007 to assess acceptability of PIHCT and the factors influencing its uptake among TB patients in Addis Ababa. Institution-based, cross-sectional study was conducted and 423 TB patients interviewed. Most of the patients were initiated for HIV testing by their TB treatment supervisor 402(98.5%). Among those who were initiated by their treatment supervisor for HIV testing, 266(66.2%; 95%CI= 61.6-70.8) had under gone HIV testing. Adjusted correlates of acceptability of PIHCT include younger age group (20-24) (AOR=3.0, 95% CI=1.2-8.1), primary education (AOR=2.0, 95% CI=1.04-3.8), secondary and above education (AOR=1.9, 95% CI=1.01-3.7), and recognition that any one should get tested for HIV (AOR=5.5, 95% CI=1.4-21.7). The reported barriers for acceptability of PIHCT include no risk perception for HIV infection 54(40.3%), tested before 53(39.3%), and fear of learning positive result 40 (29.8%) of the study participants. The wide spread support, and evidence of high acceptability of PIHCT in this study holds significant promise for the control, prevention and treatment of both HIV/AIDS and TB