We studied patient outcomes by type of referral site following 2 years of combination antiretroviral therapy (cART) during scale-up from June 2006 to July 2011 in Mozambique's rural Zambézia Province. Loss to follow-up (LTFU) was defined as no contact within 60 days after scheduled medication pickup. Endpoints included LTFU, mortality, and combined mortality/LTFU; we used Kaplan-Meier and cumulative incidence estimates. The referral site was the source of HIV testing. We modeled 2-year outcomes using Cox regression stratified by district, adjusting for sociodemographics and health status. Of 7,615 HIV-infected patients ≥15 years starting cART, 61% were female and the median age was 30 years. Two-year LTFU was 38.1% (95% CI: 36.9-39.3%) and mortality was 14.2% (95% CI 13.2-15.2%). Patients arrived from voluntary counseling and testing (VCT) sites (51%), general outpatient clinics (21%), antenatal care (8%), inpatient care (3%), HIV/tuberculosis/laboratory facilities (