Background: The need to link HIV/AIDS and Sexual Reproductive Health (SRH) response is important due to the interconnectedness of HIV and SRH. Swaziland is implementing the Primary Health Care strategy which involves integration of a number of health services. However, in the early years of the HIV/AIDS epidemic, its programming and funding was prioritized in a vertical manner due to the scale and scare of the epidemic. Over the years, the country recognized that addressing HIV/AIDS and Sexual Reproductive Health and Rights (SRHR) services as totally separate entities is counterproductive in achieving targets for both HIV and SRHR. This assessment was aimed at documenting the extent of SRH and HIV integration in Swaziland. Methods: A mixed-methods approach was used to document the extent of SRHR and HIV integration. The quantitative approach included secondary data analysis using national data and reports on SRHR and HIV integration indicators between 2009 and 2016. The qualitative approach included in-depth desk review of documents as well as key informant interviews. Results: RMNCAH and HIV integration is supported by enabling policy environment across all levels. In 2016, 94% accessed HIV services and 95% of those testing HIV positive were initiated within the RMNCAH platform, while 92% of clients attending FP services eligible for HIV testing were tested and 75% of those tested HIV positive linked to care and treatment. An observed increasing trend of HIV testing within TB clinics from 66% in 2012 to 92% in 2016. A significant p-value (pr>Chi2 ≤0.0001) indicating HIV testing in STI clinics. Conclusion: The bi-directional integration of RMNCAH and HIV provides a concrete ground for reaching the ambitious UNAIDS targets (90-90-90). This integration is not only logic to the health delivery system; it’s also beneficial to the clients. Having one strategy, one coordinating structure and one M&E system may significantly lead to attainment of the UN-SDGs. Recommendations: Programmers should outline a minimum package of integration is paramount in scaling up HIV and RMNCAH integration. Continuous capacity building including supportive supervision and mentorship is needed to integrate health services.