Background: Oral health forms an important aspect of overall general health. HIV infection causes progressive deficiency in immune system leading to many opportunistic infections and wide range of oral manifestations. Oral manifestations have found a place in many classifications and staging related to HIV infection. Many earlier studies on oral manifestation of HIV are based on western population only. Aim: This study highlights the distribution of oral manifestation among HIV patients under HAART regimen. Materials & Methods: Among the randomly selected patients have been undertaken in the government Rajaji Government Hospital, Madurai. Results: Overall, mucosal hyper pigmentation was the commonest oral lesion seen followed by oral candidiasis, recurrent ulcers, periodontitis and parotid gland enlargement. Conclusion: The HAART regimen significantly reduces the prevalence of oral manifestations of HIV infection and our data suggests and emphasizes HIV Oral Lesion’s (HIV–OL’s) as clinical markers of disease progression and reflects the viral load failure