Background: Carcinoma of the cervix is the most common female genital tract malignancy in Nigeria. Immunosuppression has been linked with acquisition and persistence of human papilloma virus infection, which is known to trigger changes in the cervical epithelium resulting in cancer of the cervix. Objectives: The objective was to determine the prevalence of cervical squamous intraepithelial lesion in human immunodeficiency virus (HIV) positive women receiving care at the Federal Teaching Hospital, Abakaliki in Nigeria, as well as the pattern of abnormal cervical smear in HIV-positive women. Materials and Methods: The study was a prospective cross-sectional study of 206 HIV-positive women attending the HIV clinic at the Federal Teaching Hospital Abakaliki. Papanicolaou smear was collected. Statistical analysis of the results was performed using the SPSS version 16 software package. Results: The prevalence of squamous intraepithelial lesion (SIL) was 6.3% in HIV-positive patient. Of those with abnormal cervical cytology, 35/206 (17%) had inflammatory smear, 16/206 (6.3%) had low-grade SIL, and 4/206 (1.9%) women had Trichomonas vaginalis . Conclusion: The prevalence of low-grade SIL among women infected with HIV in this study was high. The abnormal cervical smear were inflammatory smears, low-grade cervical SILs, and Trichomonas vaginalis infection.