It is well known that HIV–infected patients are at a risk of accelerated senescence systemically. Studies on corneal endothelium evaluating the effect of accelerated senescence have shown conflicting evidence. Therefore, whether accelerated senescence affects the corneal endothelium HIV infection is questionable. In our study, it was found that patients with HIV–infection have a lower endothelial cell count and higher average cell size as compared to seronegative individuals. It was also noted that patients with longer duration of HIV infection have increased central corneal thickness. Thus, specular microscopy can be used as a preoperative tool to assess apparently healthy corneas in HIV–infected patients.