Abstract： Objective To study postoperative sepsis in HIV/AIDS patients who underwent abdominal operations. Methods A retrospective analysis was performed to study 34 HIV/AIDS patients treated between January 2009 and December 2010 at the Shanghai Public Health Clinical Center Affiliated to Fudan University. Results There were 31 males and 3 females in this cohort with a mean age of 45 ±13 years. Nineteen patients developed postoperative sepsis. The levels of preoperative CD4, postoperative CD4, preoperative CD4/CD8, and postoperative platelet were significantly lower than those without sepsis (all P<0.05). Among 19 patients with a preoperative CD4 cell count less than or equal to 200×106/L, the incidence of postoperative sepsis rate was 84.2%(16/19), and for those with a preoperative CD4 cell count greater than 200×106/L, the incidence of postoperative sepsis rate was 20.0% (3/15), the difference was statistically significant (P<0.05). There were 3 postoperative deaths. Conclusion CD4 cell count can be used as a predictive marker for the development of postoperative sepsis in patients with HIV/AIDS.