Although men who have sex with men (MSM) have the highest human immunodeficiency virus (HIV) prevalence in Guatemala, prevention efforts have been focused on other vulnerable populations. Respondent-driven sampling was used to recruit 444 MSM in Guatemala City to explore factors related to HIV testing among MSM. About 56% of participants reported HIV testing in the past 12 months, which was associated with a public MSM status (adjusted odds ratio (AOR) 2.08; 95% CI 1.02–4.26), participating in peer HIV prevention intervention (AOR 3.71; 95% CI 1.86–7.43), having at least one casual male partner (AOR 2.16; 95% CI 1.11–4.20), and practicing only insertive anal sex (AOR 3.35; 95% CI 1.59–7.09). Men with comprehensive HIV knowledge (AOR 2.63; 95% CI 1.38–5.02) were also more likely to have been tested. Further interventions in Guatemala targeting the most hidden MSM are needed.