HIV infection is global disease with more prevalence in low/middle income countries including Nigeria. It is associated with many complications and manifestations which may be infective or non-infective. The non-infective manifestations include pellagra which results from deficiency of niacin and tryptophan. HIV/AIDS causes pellagra through poor intake, absorption or metabolism of niacin/or tryptophan. Pellagra has characteristics presentations of dermatitis, diarrhea and dementia. We report a case of a 32 year old woman who was being managed for HIV infection, presented with pellagra. She responded well to niacin replacement therapy. The aim of this case report is to highlight HIV infection as a cause of pellagras.