This report describes the development of an electronic medical records system (EMRS) for an HIV/AIDS care and treatment programs in Nigeria. The rapid scale-up of HIV treatment with antiretroviral therapy (ART) in sub-Saharan Africa (SSA) brought with it many challenges, including the need for EMRS in settings with no prior experience. In response to this need, there have been a diverse set of approaches to EMRS implementation in SSA. Each program’s unique experiences and approaches provide valuable learning opportunities, and sharing these solutions, along with their challenges, can benefit other programs with similar needs, preventing the cycle of “reinventing the wheel”. (Source: International Journal of Medical Informatics).