Background: Haematological abnormalities are common in people living with HIV and may reflect immune dysfunction, chronic inflammation, nutritional deficiencies, co-infections or treatment-related effects. This study evaluated the haematological profile of adults with HIV and examined its relationship with CD4 cell counts. Methods: A hospital-based cross-sectional observational study was conducted in the General Medicine services of National Institute of Medical Sciences and Research, Jaipur, over 18 months. Adults aged ≥18 years with confirmed HIV infection who provided informed consent were included. Patients with pre-existing haematological or congenital blood disorders and pregnant women were excluded. Demographic and clinical data were recorded. Complete blood count, red-cell indices, peripheral smear examination and CD4 T-lymphocyte counts were assessed. Data were analysed using SPSS version 25 and Microsoft Excel. Results: Fifty participants were included; mean age was 35.83±11.25 years and 58.0% were female. All participants were receiving antiretroviral therapy. Pallor was present in 26.0% and lymphadenopathy in 20.0%. Mean haemoglobin was 9.79±1.07 g/dL, total leukocyte count 5200.00±884.65 cells/mm³, platelet count 169,166.67±14,116.49 cells/mm³, mean corpuscular volume 87.00±1.67 fL, mean corpuscular haemoglobin 29.50±1.25 pg and mean corpuscular haemoglobin concentration 33.25±0.26 g/dL. Mean CD4 count was 424.62±168.45 cells/mm³. The source study described greater haematological abnormalities among participants with lower CD4 counts. Conclusion: Anaemia was the principal haematological abnormality in this treated cohort, while mean leukocyte and platelet counts were relatively preserved. Routine complete blood count assessment alongside CD4 monitoring may provide a practical adjunct for identifying patients requiring further evaluation.