Despite the several studies conducted on lipid levels among people living with HIV/AIDS on combination antiretroviral therapy (cART), drawing causal conclusions from these studies regarding the lipid profiles of individuals living with HIV/AIDS remains challenging.We analyzed the lipid profile pattern among PLWHA on cART. The study was a cross-sectional analysis at Cape Coast Teaching Hospital’s HIV/AIDS clinic. This study spanned the periods of December 2016 to May 2017 among 272 PLWHA. Data on socio-demographic characteristics, clinical history, and Cluster of differentiation (CD4) count were collected. Enzymatic-linked colorimetric methods carried out lipid analyses and a multiple logistic regression model was used to assess factors associated with dyslipidemia among cART-positive and naïve PLWHA. cART positive PLWHA had a significant increase in hypercholesterinemia [157(85.8%), p < 0.0001)], LDL-C [ 153 (84.1%), p < 0.0001)] and Non-HDL-C [167 (91.8%), p < 0.0001) than cART naive PLWHA. Being female [(adjusted odds ratio, AOR=3.10; 95% confidence interval, CI= (1.31-7.32), p < 0.05)] and duration of therapy (> 24 months) [(AOR=3.29; 95% CI = (1.05-10.30), p < 0.05)] were factors that contributed to dyslipidemia among cART-positive PLWHA. Besides, CD4 + count (>500mm 3) contributed to high LDL-C among cART positive PLWHA [(AOR=1.96; 95% CI = (1.20-19.30), p < 0.05)]. Our findings suggest that lipid metabolism abnormalities (dyslipidemia) are common in cART-positive PLWHA. Thus, there is a need for the country’s HIV/AIDS program to establish laboratory surveillance of lipids for both cART-positive PLWHA with special attention.