The advent of highly active antiretroviral therapy (HAART) has led to significant reductions in morbidity and mortality; however, adverse effects are common, and may lead to discontinuation of therapy, dose interuption, and significant reductions in quality of life. Prompt identification and management of adverse effects are crucial to ensuring adherence to treatment and the success of antiretroviral therapy (ART). In May 2007, the KwaZulu-Natal (KZN) Pharmaceutical Services Directorate, in collaboration with the Strengthening Pharmaceutical Systems Program, implemented by Management Sciences for Health, implemented a project to intensively monitor ARV medicine adverse events (AEs). This is a report of the findings.