Dhungana GP, et al. - Using secondary data taken from registers maintained at antiretroviral therapy (ART) centers, a retrospective cohort study was conducted to evaluate isoniazid preventive therapy (IPT) initiation and completion rates in the Far-Western Region (FWR) of Nepal. Participants in the study were all people living with HIV (PLHIV) registered for care between January 2016 and December 2017 in 11 ART centers. Of the 492 PLHIV included, at registration, 477 had no active tuberculosis. Findings revealed that 3 out of 10 eligible PLHIVs received IPT in Nepal's FWR. The completion rate was good among those receiving IPT (94.3%). The HIV care program should investigate the possible reasons for this low coverage and take context-specific corrective action. Factors significantly associated with IPT initiation include being more than 60 years of age, a migrant worker, and not being on ART.