Infection with HIV is independently associated with an increased risk of cardiovascular disease, while therapeutic use of HAART has been shown to increase the risk of metabolic derangements which may have potentially damaging effects on the cardiovascular system. The study was carried out to assess the pattern of electrocardiographic (ECG) and echocardiographic (ECHO) abnormalities among HAART experienced and HAART naive HIV patients. This was a cross-sectional study of one hundred (100) HIV seropositive subjects and 100 age and sex matched controls to assess cardiovascular risk among HIV seropositive persons in Port-Harcourt, Rivers State, Nigeria. The results showed that the prevalence of ECG abnormalities among the cases was 49 (49%) compared to 42 (42%) of the controls (c2=0.020, p=0.886). Sinus tachycardia was the most common ECG abnormality in all study participants and was present in 37 (37%) of the control subjects when compared to 21 (21%) of the cases and this was statistically significant. T-wave inversion and prolonged QT interval were the next two most prevalent findings seen in 23% and 18% of the cases compared with 8% and 5% of the controls respectively and these were also statistically significant (p=0.004 and 0.003 respectively). Among the cases 10% had grade 1-2 diastolic dysfunctions compared with 23% of the controls and this was statistically significant (p=0.013). Ninety percent (90%) however had normal diastolic function compared with 77% of the controls. Systolic dysfunction was found in only 2% of the HAART experienced cases compared to 10 (10%) of the HAART naive controls and this was also statistically significant (p=0.017). The study showed that electrocardiographic and echocardiographic abnormalities are common in HIV seropositive patients with ECG abnormalities being more common among the HAART treated subjects. These ECG & ECHO abnormalities generally increase the cardiovascular risk profile of PLWHIV/AIDS and are independent predictors of CV mortality hence the need for prompt diagnosis and interventions.