World wide it is estimated that 40.3million patients are living with Human Immunodeficiency Virus (HIV) and 90% of these are in developing countries. About 70% of patients with HIV infection experience a pulmonary complication during life, and additional pulmonary pathology is often unexpected finding at autopsy. The clinical and radiographic presentation of lung disease associated with HIV infection is non-specific. Chest radiography has limited sensitivity for the detection of early infection in immunocompromised patients. The absence of radiographic findings however does not rule out pulmonary disease. Tuberculosis (TB) being the main opportunistic pulmonary infection contributing to mortality among HIV infected individuals, it is important to diagnose and treat it early. The present study is undertaken to establish the role of CT scan, particularly thin section CT (HRCT), in the early diagnosis of pulmonary disease in symptomatic HIV seroreactive patients with normal chest radiograph. 56 HIV seropositive patients who had pulmonary complaints with normal chest radiograph were selected. A HRCT scan of the chest was performed, HRCT findings were correlated with clinical features and other investigations. 19 (36.53%) out of 52 patients with normal chest radiograph had abnormal HRCT chest findings. HRCT of the chest should be done and must be included in the diagnostic algorithm for detecting early lesions in HIV seropositive patients with pulmonary symptoms with normal chest X- ray.