Cervical cancer is the second leading cause of cancer mortality in women worldwide, and the leading cause in Africa. There is uncertainty in the role of HIV infection as a risk factor for invasive and preinvasive cervical lesions, particularly in African populations. In a case-control study in Dakar, Senegal, we studied 150 women with invasive cervical cancer (ICC), 92 with cervical intraepithelial neoplasia (CIN) 2 or 3, 70 with CIN 1, and 515 control women. We used logistic regression analysis to estimate associations between HIV-1 and HIV-2 infection and the risk of cervical neoplasia. We found large increases in the risk of ICC and CIN 2-3, but not of CIN 1, associated with the presence of either HIV-1 or HIV-2 infection (odds ratios of 6.5 and 10.4 for ICC and CIN 2-3). Our analysis thus shows increases in the risk of both advanced and early cervical pathology associated with HIV infection in an African population.