Objective To know about the prevalence of recent human immunodeficiency virus (HIV) testing (in the last 12 months) and its associated factors among men who have sex with men (MSM) in western China. Methods A total of 1 245 MSM were recruited by convenient sampling from multiple sources and areas in Chongqing and Sichuan regions. The participants were interviewed with anonymous self-administered questionnaire and received HIV testing at the same time. Multivariate logistic regression was used to identify the factors associated with recent HIV testing behavior. Results A total of 1 245 questionnaires were completed, and 1 199 (96.31%) were valid and included for analysis. Of the 1 199 MSM, 43.45% (521/1 199) reported having HIV testing in recent one year. The overall HIV antibody positive rate was 21.35% (256/1 199) in the present study; the HIV positive rate was significantly higher in those did not receive HIV testing in recent one year compared with those received HIV testing (24.93% vs 16.70%, χ²=11.876 3,P=0.000 6). Logistic regression analysis revealed that a score >10 in HIV/AIDS knowledge test (OR=1.593, 95%CI:1.164-2.180) was associated with increased recent HIV testing among MSM, and the factors associated with lower HIV testing rate in recent one year included not receiving free HIV counseling voluntarily over past years (OR=0.284, 95%CI:0.218-0.371), self-perceived low prevalence of HIV infection among MSM in city/district/county they were living (OR=0.570, 95%CI:0.386-0.841), and occasionally/never using condoms during anal sex with men in recent six months (OR=0.688, 95%CI:0.514-0.919; OR=0.645, 95%CI:0.421-0.987). Conclusion The proportion of recent HIV testing among MSM in western China is low, although the HIV prevalence is still alarmingly high. MSM not receiving any HIV testing in recent one year have higher HIV infection risk compared with those receiving. The community-based HIV-related risk education should be strengthened so as to further promote regular HIV testing among MSM in these high epidemic areas.