Nigeria has the second largest number of individuals living with HIV/AIDS in the world after South Africa and such people continue to die in significant numbers. There is paucity of autopsy data among HIV/AIDS deaths in Nigeria and we do not yet know nearly as much as we ought to about the autopsy pathology in HIV/AIDS disease in the country. The objective of this study was to describe autopsy findings in HIV/AIDS cases in Lagos University Teaching Hospital (LUTH). LUTH is a tertiary health centre with the highest autopsy rate in Nigeria and is located in Lagos, South-west Nigeria, an urban centre with a population of more than 15 million people. The patient population for this study included HIV/AIDS autopsy cases that were diagnosed pre-mortem, cases with AIDS-defining diseases and cases that were diagnosed post-mortem using two different HIV test kits. There were 2,278 deaths and 754 autopsies carried out over the one year study period giving an autopsy rate of 33.1%. A total of 44 patients (21 males and 23 females) were found to be HIV positive representing a prevalence of 5.8%. Of the 44 HIV positive patients, 23(53.3%) were diagnosed ante mortem while 21(47.7%) were diagnosed in the autopsy room. The ages of these patients ranged between 6 hours and 69 years with the peak age in the 30 – 39 year age group. Infections were seen in 27(61.4%) cases, out of which 13(48.1%) were AIDS defining infections. Eight of these patients had tuberculosis. Two (4.5%) patients had neoplasms (one case each of non-Hodgkin lymphoma and pleomorphic sarcoma). This study showed a demographic pattern of HIV infection comparable with previous national surveillance data. However the seroprevalence found in this study is slightly higher than the most recent national surveillance data. The use of HAART has drastically reduced the prevalence of AIDS defining illnesses but requires access and compliance to the use of the drugs on the side of the patient. Thus intensification of current awareness campaigns is required to sensitize the public on the need to encourage HIV positive patients to use their drugs as prescribed.