Neurological or neuromeningeal manifestations are common during HIV infection.The diagnosis must be rapid because the patient's life may be at risk.This is a retrospective descriptive study conducted at the HIV/AIDS/STI Reference Center in Oran, based on the medical records of patients followed for HIV infection between 2022 and 2025. HIV serology was confirmed in all patients. Analysis of encephalitic and paraclinical clinical signs was performed during the patients' hospitalization.Demonstrate the frequency of neurological or neuromeningeal manifestations in HIV-infected patients in correlation with the degree of immunosuppression, to describe the epidemiological and clinical profile, and the evolution under treatment.We collected data from 160 patients living with HIV followed at the CDR, 44 of whom presented with neuro-meningeal manifestations, representing a prevalence of 27.5%. The age range was from 25 to 54 years. Clinical signs observed included: subacute headaches (72.73%); altered mental status (13.64%); seizures (11.36%); and balance disorders (9.1%). Diagnosed opportunistic infections included: cerebral toxoplasmosis (25%), tuberculous meningoencephalitis (20.45%), cryptococcal meningitis (22.73%), LEPM4 (9.1%), cerebral lymphoma (13.63%), and listeriosis (9.1%). Diagnostic methods relied on epidemiological and clinical findings, imaging (CT/MRI), lumbar puncture results, CSF PCR, CSF parasitology, and laboratory tests. More than half of the patients had a CD4 count <50/mm³ and a high HIV viral load. Appropriate treatment for each neuro-meningeal manifestation was prescribed as soon as the diagnosis was made; antiretroviral therapy was initiated on average 20 days after the onset of opportunistic infection. The mortality rate was 27.27%.Neuro-meningeal involvement is a serious condition affecting people of all ages living with HIV. The clinical presentation varies depending on the type of opportunistic infection affecting the brain. These infections are common in cases of severe immunosuppression, and the prognosis is guarded despite antiretroviral therapy.Neuromeningeal manifestations are a significant cause of morbidity and mortality during HIV infection. Early diagnosis followed by appropriate treatment of any opportunistic brain infection and effective antiretroviral therapy allows for better management of these manifestations.