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Issues: Scaling up of clinical HIV care and treatment services in resource poor settings gives rise to large cohorts of patients in chronic care. This requires monitoring of individual patients, cohorts and programs; a complex task which can only be successfully performed by using an electronic database. Description: We developed a freeware MS Access database, ART Journal, paper tools for patient monitoring (and for data entry) and a user manual. These tools are based on a database application specifically developed for an expanding cohort of HIV patients in Cambodia, a resource poor setting. In the database, patients are identified by a unique identifier; to protect confidentiality their name and address are not recorded. Clinical parameters, WHO-stage defining conditions, laboratory parameters, CD4, visits, prophylactic drug use, antiretroviral drugs with start and stop dates and side-effects are stored in the database. The database produces electronic patient and program reports. The user manual not only explains how to install and use the database and the patient and program reports, but also explains how to set up the data-collection system in the clinic. The database runs on any PC using Windows XP and MS Access 2003. Lessons learned: An appropriate database greatly facilitates follow-up of individual patients and gives a better overview of program performance and outcomes. Recommendations: To allow other programs to benefit from these possibilities, the database is available as freeware at http://telemedicine.itg.be/telemedicine/site/Default.asp. Although technical requirements are limited, the program should have a reliable computer and a person with minimal computer and English language skills.