HIV infection, through various mechanisms causes a derangement in physical growth and sexual maturation. Although ART use promotes restoration of immune function and improvement in quality of life in HIV infected subjects, variables such as poor adherence to drug, duration on ART and unsuppressed viral load may negatively influence physical growth and sexual maturity ratings (SMR) in HIV infected children. However with intervention and good adherence to drugs, many have achieved viral suppression thereby making HIV infection a chronic illness rather than a progressive fatal one. The aim of this study was to determine the physical growth and sexual maturation in HIV infected males aged 8-17 years in Abakaliki among children who are undergoing HAART. The study was a case-control hospital based study, involving 80 HIV infected males aged 8-17 years who were matched for age and socio-economic class with 80 HIV uninfected controls. The study participants were recruited consecutively over a six month period. The physical growth involving the heights, weights and BMI of subjects and controls were measured and Z scores for age derived for height, weight and BMI respectively. The stages of sexual maturation (testicular size and pubic hair development) were assessed using the method proposed by Marshall and Tanner. All the subjects were on highly active antiretroviral therapy and the average duration was 5.8 years. Surprisingly, 55.8% of the subjects had unsuppressed viral load (>1000 copies/ml) while only 44.2% had suppressed viral load (< 1000 copies/ml). Most of the study participants 96 (60%) were of lower socio-economic class while 64 (40%) were from upper socio-economic class.