Kuehnast M, et al. - Thirty-three cases were assessed, ie, 20 of the local cases and 13 published cases in order to evaluate the literature on the imaging appearances of neurocysticercosis (NCC) and HIV co-infection and contrast it with the local cases. Parenchymal brain cysts was noted in the published cases, whereas both parenchymal and subarachnoid cysts were seen in the local cases. The published cases also held intra-axial cysts, whereas the local cases possessed both intra- and extra-axial cysts. Predominantly cystic lesions was noted in the published cases, whereas both cystic and granulomatous lesions were observed in the local cases. No variations among cases with a CD4 count of < 200 cells/mm³ and cases with a CD4 count of ≥ 200 cells/mm³ was seen, though interestingly, racemose cysts was observed in 3% of the cases with a CD4 count of < 500 cells/mm³, compared with 50% of the cases with a CD4 count of ≥ 500 cells/mm³. In conclusion, NCC is very common in South Africa and may obscure the diagnosis and treatment of patients with concomitant HIV infection. Patients with a “low” CD4 count may manifest with atypical lesions, lingering the diagnosis of NCC. Immediate initiation of highly active antiretroviral therapy could lead to patients manifesting with more classical symptoms and imaging features, hence enhancing outcomes.