To identify the factors that affect the accessibility and acceptability of Voluntary Counselling and Testing (VCT) services among High Risk Groups for HIV in NWFP. A cross sectional study was conducted in two districts of N.W.F.P. namely Peshawar and Abbotabad from August 2007 up till January 2008. A total of 153 participants were interviewed from high risk group by convenient sampling. The high risk group included commercial sex workers and injection drug users. Information was also gathered from in-charges of VCT centers. The data were collected in two phases, in the first phase data were collected in Peshawar while in the second phase data were collected in Abbotabad. Out of 153 respondents 102 (67%) were interviewed in Peshawar while 51 (33%) respondents were interviewed in Abbotabad. A total of 153 respondents were interviewed, that included commercial sex workers (123) and injection drug users (30). Mostly the participants were young with a mean age of 24 +/- 8.8 years. As far as transmission of HIV was concerned 57% reported that HIV was transmitted through sexual contact, 09% said it was transmitted by contaminated instruments and syringes and around 11% reported its transmission by eating with persons having HIV/AIDS while 04% said it was transmitted by hugging/kissing. The level of knowledge about VCT was very low and about 27% of the participants had heard about VCT center. Only a small number i.e., 16 out of 153 partipants visited VCT centres. The study concluded that there is lackof awareness among high risk group regarding VCT and those who have heard about VCT (27%) only a few had visited the VCT center. The awareness campaign about VCT should target communities in general and high risk group in particular.