Background: CD4 counts vary in different populations. The present study was conducted to determine CD4 counts in different World Health Organization (WHO) clinical stages in antiretroviral therapy naïve individuals and to find out optimum CD4 cutoffs. Method: Data of adult HIV seropositive patients who underwent CD4 count and total lymphocyte count (TLC) testing were included for analysis. The severity of immunosuppression was graded based on WHO criteria. To establish optimum CD4 cutoff values, receiver–operator characteristics (ROC) curves were generated. Results: Of 754 patients, 52.2% had CD4 counts <200 cells/mm³, but only 2.3% belonged to WHO stage IV. Newer CD4 cutoffs generated were 280, 120-280, <120 cells/mm³. Spearman rank correlation between CD4 counts and TLC was found to be weak (r = .32). Conclusion: The cutoff values of CD4 counts for HIV disease may need to be revised for India. Regular CD4 count estimation is a must for monitoring disease progression in people living with HIV/AIDS.