Introduction Acute human immunodeficiency virus type 1 infection is a clinical and biological misleading and often undiagnosed illness. Laboratory studies frequently demonstrate abnormalities. Acute rhabdomyolysis is rarely reported. Exegesis Authors report the case of an African man who presented with acute fever, cough, diarrhea, conjunctivitis, thrombocytopenia, lymphopenia, and rhabdomyolysis without other possible cause. HIV test and detection of plasma p24 antigen were initially negative but were controlled positive and associated with high level of viral RNA. Conclusion Symptomatic primary human immunodeficiency virus infection presenting with acute rhabdomyolysis was diagnosed. Diagnosis of primary HIV-1 infection must be considered in young people and patients at risk who present with acute rhabdomyolysis and fever.