ABSTRACT Background: Enterococci that colonize the intestinal tract of immuno-compromised patients are an important cause of infection as well as nosocomial spread such as urinary tract infection (UTI), bacteremia, and endocarditis and wound infection. Data on the prevalence of Vancomycin resistant Enterococci (VRE), its antimicrobial susceptibility patterns and associated factors are scarce in the present study area. The aim of this study was to determine the prevalence of VRE colonization among HIV positive patients attending ART clinic at West Amhara Government Hospitals. Method: A cross-sectional study was conducted from 1 February 2017 to 31 May 2017. A total of 349 patients were included in the study. Pretested structured questionnaire was used to collect socio-demographic and clinical data. Identification and confirmation of Enterococci from stool sample was performed based on standard bacteriological procedures. Antimicrobial susceptibility testing was done using kirby-bauer disk diffusion method on Muller Hinton agar plate as per the standard protocol and resistance profile of the isolates were determined according to Clinical and Laboratory Standards Institute (CLIS). Result: The overall colonization rate of Enterococci was at 220/349 (63%). The VRE colonization was at 17 (7.7%; 95% CI:4.9-12.0). Of Enterococcal isolates tested for antimicrobial susceptibility, 142 (64.5%) were resistant to two or more antibiotics classes. Antibiotic treatment (>2 weeks) and history of hospital admission in the last six month were statistically associated for VRE colonization (AOR= 10.18, [95% C.I, 1.9-53.20]; P-<0.012) and (AOR= 20.17; [95%C.I, 5.22-77.93]; P-<0.001); respectively. Conclusion: The prevalence of VRE among ART patients was at 7.7%. History of hospital admission and previous administration of antibiotics usage greater than two weeks were the identified associated factors for colonization. The emergences of VRE with high rates of multidrug resistance enterococci colonization need a periodic surveillance of antimicrobial susceptibility to detect emerging resistance and prevent the spread of drug resistance. Keywords: Vancomycin-resistant, Enterococci, HIV