Introduction: Home-based care services like improved water supply, sanitation, and hygiene (WaSH) practice are essential for people living with HIV/AIDS (PLWHA) to improve their quality of life. The negative impact of inadequate WaSH services is more pronounced among HIV-infected individuals leading them to low economic productivity, poor-nourished, immuno-compromised, and death. Objective: To determine access to basic water supply, sanitation and hygiene service and associated factors among people living with HIV/AIDS in Bahir Dar city administration. Materials and method: A community-based cross-sectional study was conducted in Bahir Dar city from December 01/2020 to December 30/2021. A simple random sampling technique was employed and a total of 421 study participants were interviewed using a pretested and interviewer-administered questionnaire. Data was coded and entered to Epi-data version 3.1 software and analyzed using SPSS version 20.0. Descriptive statistics was computed and presented in tables and texts. Bivariable and multivariable logistic regressions was used to determine the determinant factors associated with sanitation and hygiene service. Finally, variables with a p-value of < 0.05 was considered as a statistically significant determinant factor associated with sanitation and hygiene service. Results: A total 413 study participants took part in this study. Nearly 94 % of the them had access to basic water supply, 24 % had basic sanitation services and 67.6% had hygiene services. Live in their own houses (AOR=11.56; 95%CI; 5.65,23.63), live in the kebele rental house (AOR=6.30, 95%CI: 2.97, 13.36), and latrine ever emptied (AOR=2.69, 95%CI;1.59, 4.55) were significantly associated with basic sanitation service. While 18-40 years of age (AOR=2.57,95%CI: 1.48, 4.48), daily laborer (AOR=0.51, 95%CI: 0.27, 0.95), monthly income > 2000 birrs (AOR=2.57, 95%CI:1.48, 4.47), live in the kebele rental house (AOR=0.53, 95%CI: 0.29, 0.98), drinking water kept in the separate container (AOR= 5.37, 95%CI: 2.62, 11.00), emptied their latrine (AOR=2.13, 95%CI;1.29, 3.51), household supervision by health extension workers (AOR=10.11, 95%CI: 3.82, 26.71) were significantly associated with basic hygiene service. Conclusion: The sanitation and hygiene need of the study participants was not fulfilled. Therefore, Promote and demonstrate cost effective latrine construction materials (sanitary- market) and hand washing device need to improve sanitation and hygiene service. Keywords: - PLWHA, Water, Hygiene and Sanitation. Bahir Dar city