Background: Nigeria carries the second highest burden of HIV/AIDS disease in the world. Several studies have shown a higher prevalence of pre-invasive and invasive cervical pathology among HIV positive population compared to their HIV negative cohorts. Aim: The aim of this study was to look at the prevalence of cervical intraepithelial lesion among HIV positive women compared to their HIV negative counterparts seen at the University of Abuja Teaching Hospital, Gwagwalada. Subjects and Methods: This was a comparative analytical study of 135 HIV positive and 135 HIV negative women assessing healthcare services in the Special Treatment clinic, Gynaecological and Family Planning clinics of the hospital. Pap smear was collected from each of the study groups. The specimens went through processing and the slides were read by a Consultant Histopathologist. The data was analyzed using SPSS version 16 and level of significance was set at P<0.5. Results: Sixty three (46.7%) of the HIV positive and 111 (82.2%) of the HIV negative groups were married. Abnormal Pap smear results were seen in 17 (12.6%) HIV negative women and 76 (56.3%) HIV positive women, Six HIV positive women had CD4 count of <200 cells/ml. Among them, 3 had moderate cervical dysplasia while the other 3 had severe cervical dysplasia. Conclusion: The study has demonstrated that abnormal cervical smear is more prevalent among HIV positive than HIV negative women. Therefore, there is a need to incorporate routine cervical cancer screening services into the existing HIV/AIDS programmes in Nigeria.