India's initiative to provide structured antiretroviral therapy has raised hope among people living with HIV/AIDS to lead a more productive life. However, from a programme perspective, providing structured antiretroviral therapy has got high cost implications and there are ethical issues related to the provision of second line therapy in case of drug failure. To date, evidences on the cost implications of running ART programmes are mostly from developed and African countries. The current study attempts to work out the cost implications of running the public funded ART centre in the state of Gujarat. Data on cost and patient load were collected through actual field visits to the centre. Using incremental cost approach the cost of providing ART therapy to a patient works out to be Rs. 668 per month. These calculations are based on provision of first line therapy only. Using this costing and assuming a provision of second line therapy for 16 per cent of the cases, we estimate that India will need financial provision of Rs. 454 crore to Rs. 1342 crore for a period of five years under different scenarios to successfully implement the programme. Note: For softcopy of this paper, please contact the author - email: rbhat@iima.ac.in