We report a case of a 22-year-oldfemale patient, diagnosed to have HIV infection 8 years back. She was on antiretroviral therapy (ART) for the last 8 years. The patient had not been taking ART regularly for the last 2 years. Her CD4 count had gradually fallen to 238/mm3 from 520/mm3 over 2 years. She presented to us with complaints of headache and altered behavior for a week and focal fits for 2 days. She had holocranial, throbbing headache associated with episodes of vomiting. She was irritable and showed no interest in her surroundings. The mother found her muttering to herself for the last few days. She was scared and believed that someone wanted to kill her. Later, she had multiple fits in the form of right-sided facial twitching and clonic jerky movements of the right upper limb. There was no history of fever, neck pain, or loss of consciousness. Neurological examination was unremarkable. Her routine blood investigations were normal. CD4 count was 238/mm3. Cerebrospinal fluid (CSF) examination revealed total cell count of 30/mm3 with lymphocytic predominance. CSF protein was 68 mg/dl, while sugar was 72 mg/dl. On further testing, EBV was detected using polymerase chain reaction (PCR) test. While tuberculosis PCR, virology (including herpes simplex, varicella-zoster, cytomegalovirus, and JC virus), syphilis, toxoplasma serology, cryptococcal antigen, bacterial, and fungal cultures were negative in blood and CSF. The quantitative viral assay showed a high level of EBV in CSF (42,864 copies/ml). Magnetic resonance imaging of the brain revealed T2/fluid-attenuated inversion recovery hyperintensities involving the left frontal cortex left thalamus and right medial temporal cortex [Figures 1 and 2]. The patient was started on antiviral therapy with valganciclovir considering the diagnosis of EBV encephalitis. The patient completely recovered over the next few weeks. She was discharged on antiepileptic and ART.