Unique nature of human immunodeficiency viruses (HIV) outbreak in Ratodero , Larkana, Pakistan I diagnosed many cases of HIV patients and referred them to concerned centers located at larkana ( for treatment of Adult HIV patients) and at karachi ( for treatment of children HIV patients), under suppervision of SACP ( Sindh Aids control program) for treatment. I noted most of patients didn\'t get treatment and were sent back to their homes with advise to come back after 6-12 weeks, although they all were having positive reports of HIV from Reputed laboratories like Aga Khan Lab and PPHI. During the 6-12 weeks duration wait , babies started to get their condition worst as they were devoid of treatment (ARV therapy) , few babies died. Last year on 23 April 2019, one HIV positive baby died , and his death made this thing to happen in media , that baby was relative of a media person working at KTN News Karachi. I suspected HIV in small kids mainly on symptoms , this is again first time in world to find such a lethal disease on symptomatology basis , as ill babies came to my clinic , i examined and suspected immunocompromised status in those babies because they all were having history of failure to thrive , mostly pneumonia , fever , Gastroenteritis , patients were having too many medicines , too many prescriptions , almost all routine blood tests ,but nothing to work and i advised them to go for HIV screening from reputable labs like Aga khan lab and PPHI. I am urologist and Guinness world record holder doctor since 12 years.I do general practice for the sake of my home town only , I diagnosed about 15 children HIV reactive , ( 12 from PPHI and 3 from Aga Khan Lab ) The most probable cause of this HIV outbreak seems to be exposure to unsafe health care practices, specifically reuse of injection equipment (syringes and needles) and drip sets by untrained health care providers practicing in and around Ratodero area. On my demand/ request through media , provisional secretary health arranged a camp for mass screening of local population . from 24 april 2019 , up to 13 November 2020 about 50000 people have been screened and more than 1500 patients have been diagnosed, including more than 1300 small children aged between 1 year to 10 years . This disease was thought to be a disease of high risk population , but here in Ratodero it was in general population , that was very much astonishing, therefore it was all the more important to ascertain the precise mode of transmission of this outbreak .