Background: Pediatric HIV is a major world health problem, which is progressing at an alarming rate. Ocular complications in HIV patients make management of such patients more difficult; if such manifestations can be picked up early, better management results could be achieved with such patients. Present study was aimed to study ocular manifestations in children (<12 years) with positive HIV status at a tertiary hospital. Material and Methods: Present study was single-center, prospective, observational study, conducted in children of 2-12 years of age, affected with HIV/AIDS, attending antiretroviral therapy (ART) center of the institute, underwent a thorough ophthalmologic evaluation for ocular involvement. Results: In present study, total 460 children underwent ophthalmologic evaluation, 88 children had ocular involvement (19.13 %). Majority were from 6-9 years age group (43.18 %), were boys (54.55 %) & mean age was 7.53 ± 3.81 years. Anterior segment manifestations noted were allergic conjunctivitis (20.45 %), dry eye (19.32 %), hordeolum (12.5 %), molluscum contagiosum (1-bilateral) (4.55 %), blepharitis (4.55 %), herpes zoster ophthalmicus (without keratitis) (3.41 %). Posterior segment manifestations were retinal perivasculitis (13.64 %), CMV retinitis (4.55 %), isolated cotton wool spot (4.55 %), toxoplasma (3.41 %), choroidal tubercle (2.27 %), Roth spots (2.27 %). In children with CD4 count of 200-500 cells/mm3 ocular manifestations noted were hordeolum, blepharitis, molluscum contagiosum, optic neuritis while in children with CD4 count of <200 cells/mm3 ocular manifestations noted were CMV retinitis, herpes zoster ophthalmicus, retinal vasculitis. Conclusion: Ophthalmic manifestations of HIV infection are diverse. Both anterior and posterior segments of the eye can be involved. Early detection of the ocular manifestations of HIV/AIDS is critical since this has implications for the prognosis of the disease.