: Abnormalities in cerebral MRI are frequently reported in persons living with HIV (PLWH). We compared clinical cerebral MRI reports in 59 PLWH and 29 lifestyle matched controls. Although clinical abnormalities were highly prevalent (47.7%), and included white-matter lesions (46.6%), microvascular disease (22.7%) and cerebral volume loss (11.4%), no differences were apparent between PLWH and controls, with abnormalities being associated with age and hypertension rather than HIV serostatus.