Men having sex with men (MSM) in India are mostly hidden due to stigma and discrimination and are at higher risk of HIV acquisition. HIV Sentinel Surveillance (HSS) pointed rising HIV burden for Chhattisgarh, an important central Indian province, with the distinction of highest HIV prevalence among MSM in India and, therefore, warrants special attention to study the role of MSM in HIV epidemic. Cross-sectional analysis of latest (2010-11) HSS data for 227 MSM in Chhattisgarh revealed 14.98% HIV sero-positivity. Older age, unemployment and receiving money for sex with a man were associated with higher HIV risk. Participants were mostly young (mean age 26 years), school-level educated (51.98%), urban residents (99.56%), doing service (46.26%), not involved in heterosexual activities (97.36%) or paid sex (68.72%). None of the participants reported injecting drug use and almost all of them (98.68%) were Kothis. Some of the observed associations lacked statistical power due to sparse data in this initial surveillance among MSM in Chhattisgarh indicating the need for studies involving larger population to understand the role of MSM in the dynamics of HIV epidemic in this state for planning appropriate interventions as the epidemic probably being concentrated among MSM in Chhattisgarh.