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Background: We aimed to study the factors associated with clinical forms of lipoatrophy in patients receiving highly active antiretroviral therapy (HAART) in Yalgado Ouédraogo Teaching Hospital, Ouagadougou, Burkina Faso. Methods: This cross-sectional review from March 10 to November 10, 2011, included a nonprobability sample of HIV-infected adults receiving antiretroviral (ARV) medications for at least 6 months and monitored in the internal medicine department. The diagnosis of lipoatrophy was clinical. Results: Three hundred patients were included. The sex ratio was 0.4 and the mean age was 42.1 ± 8.5 years. The mean duration of HAART was 73.2 ± 30.9 months. In all, 97 (32.3%) patients had lipoatrophy: 75 (25%) isolated and 22 (7.3%) mixed syndrome. Facial lipoatrophy was frequent (61.8%). Isolated lipoatrophy was associated with male sex ( P = .002) and body mass index ≤25 ( P < .05). Mixed syndrome was associated with female sex ( P = .002), age >42 years ( P < .05), physical activity ( P = .003), smoking ( P = .001), stavudine (d4T; P = .0001), or protease inhibitors ( P = .01). Conclusion: Prevention of lipoatrophy associated with HAART requires the exclusion of modifiable risk factors that we identified.