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Background Cryptococcal meningitis (CM) is an infection of the brain parenchyma and subarachnoid space by the encapsulated saprophyte yeast organisms such as Cryptococcus neoformans. Over the last twenty years, HIV has created a large and severely immune compromisized population in whom C. neoformans is a dangerous opportunistic infection. In Guinea, the prevalence of CM is unknown. We hypothesized that the occurrence of CM correlates with AIDS/ HIV prevalence.Method This retrospective observational study was carried out at the national Hospital of Conakry (Guinea) between 2001 and 2002. We describe here the epidemiological and clinical and biological characteristics of CM disease in our national hospital.Results Our data show that, 28.6 % of HIV patients with neurological symptoms had Cryptococcus neoformans in their CSF by using Indian ink staining. The median age was 36±3 years and sex ratio (M/F) was 1.8. The major complaints were fever and cephalgia, giddiness while the major complications were altered consciousness and hemiplegia. CSF was clear with low level of glucose and higher level of albumin. The means of lymphocytes in CSF was 8±2/mm3.Conclusion This data therefore becomes relevant in not only focusing of neurological symptoms associated with HIV to be toxoplasmosis but the possibility of C neoformans in these patients; particularly when they present symptoms such as headaches, giddiness and sniff neck etc. This can easily be carried out with Indian ink staining technique.