The human immunodeficiency virus (HIV) disease runs a chronic course requiring life long therapy. The introduction of highly active antiretroviral therapy (HAART) has prolonged the life of HIV infected persons. The chronic use of HAART has been associated with abnormal lipid levels or dyslipidaemia which may increase the risk of development of cardiovascular disease later in life. The study aimed to determine serum lipid profile of HIV sero-positive children on HAART at University of Nigeria Teaching Hospital (UNTH), Enugu and compare with sero-negative controls. Methodology: A hospital-based case-controlled study of HIV sero-positive children on HAART, aged six years to 17 years with their age and sex matched controls. The study was conducted over a seven-month period extending from June 2020 to December 2020. The total cholesterol, triglycerides and high-density lipoprotein-cholesterol levels were quantified using enzymatic colorimetric methods while low- density lipoprotein-cholesterol was calculated using Friedewald formula.