<p><strong>Result: </strong>A total of 861 new HIV cases were diagnosed at 14 health facilities in Gurage Zone, Central Ethiopia, from September 17, 2019 to August 1, 2024. The median age was 30 years. The majority were females 516(60.8%) and urban residents 618(72.9%). Nearly half, 378(44.6%) had primary education. Majority of new HIV cases were daily laborers 177(24.8%), housewife 152(21.3%), private employees 105(14.7%), farmers 83(11.6%) and female sex workers 77(10.8%). Number of newly diagnosed HIV cases were increased from 24 in 2019 to 225 in 2022, then declined to 216 in 2023 and 146 in 2024. Furthermore, 139(16.4%) new HIV cases had contact with known HIV-positive individuals, and 13(1.5%) injected illicit drugs. Among 611(85.7%) recency tested, 42(6.9%) new HIV cases were recently infected.</p>