Sub-Saharan Africa, particularly South Africa (SA), has the highest global prevalence of Human Immunodeficiency Virus (HIV) infection. Despite the increasing roll out of anti-retroviral therapy (ART), approximately 40% of the SA population are still ART naive. People living with HIV are at markedly increased risk of high-grade non-Hodgkin lymphoma (NHL), particularly Diffuse large B cell lymphoma (DLBCL) and Burkitt lymphoma (BL). There is also markedly increased incidence of classical Hodgkin lymphoma (HL), particularly in ART naive patients. Plasmablastic lymphoma presents in a disseminated fashion and in extra-nodal sites, though is not as frequent as DLBCL, BL and HL. The spectrum of lymphomas is thus unique in the HIV-endemic setting. Since HIV-associated lymphoma often presents with advanced, disseminated disease they may be diagnosed in the haematology laboratory with peripheral blood and bone marrow (BM) involvement. Patients with HIV-associated HL typically present with peripheral cytopenias and B symptoms, which herald BM involvement. An overview will be given of the molecular pathology of HIV-related lymphomas, including the oncogenic roles of co-infection with Epstein Barr Virus (EBV) and Human Herpes Virus 8 (HHV8) and the role of the tumour microenvironment. A practical approach to the diagnosis of these lymphomas, including the key clinical, morphological, immunohistochemical and cytogenetic/molecular features will be discussed.