Background and Objectives : HIV is evolving as a major health hazard in India. Nervous system involvement in HIV patients is common and causes significant morbidity. We tried to elucidate the proportion and aetiologies of neurological involvement.Methodology  : All patients above eighteen years and diagnosed to have HIV infection were included. Sample size calculated was118. Patients having neurological involvement during study period were analysed. Results : Neurological involvement was observed in significant number (35.6%) of patients in younger age group (25–56 years) . 48.4% with newly detected HIV infection presented with neurological manifestations. Opportunistic infections (40.5%), of which Tuberculous Meningitis (64%), topped the underlying disorders. Stroke was present in  16.7% of cases. Conclusion :  Nervous system involvement was observed to be more prevalent in young HIV patients and can be the initial manifestation. So young patients with neurological involvement like stroke should be screened for HIV.