HIV infection remains a pandemic and a leading cause of morbidity and mortality particularly in sub Sahara Africa. Although highly active antiretroviral therapy has brought about a marked reduction in morbidity and mortality, there are growing concerns on increasing non-communicable complications particularly cardiovascular and metabolic diseases in HIV disease. The objective was to do a systematic review of the clinical entities and pathogenesis of cardiovascular diseases and metabolic syndrome in HIV disease. The result shows that HIV infection and the resultant chronic immune activation; HAAR; opportunistic infections and some of the drugs use for them; and traditional cardiovascular risk factors are some of the conditions associated with cardiovascular diseases and metabolic syndrome in HIV infection. Standard cardiovascular disease screening and risk-reducing interventions should be routinely undertaken for HIV-infected persons. [Archives Medical Review Journal 2013; 22(3.000): 377-392]