OBJECTIVES: To assess hospitalization costs associated with HIV in France in 2013/2014. METHODS: The study was realized using the French Medical Information System database (PMSI, “Programme de Médicalisation des Systèmes d’Information”). All hospital stays in 2013 with HIV ICD-10 (International Classification of Diseases) codes (B20*, B21*, B22*, B23*, B24*) were extracted from this comprehensive database. Through an algorithm and a medical review, stays were classified as directly associated to HIV (low hypothesis, LH) or probably associated to HIV (High hypothesis, HH). HH included directly and probably associated to HIV stays. Each patient was followed for one year (e.g. from March 2013 to March 2014) from its first stay in hospital. Only hospitalizations excluding day care inpatient stays contributed to this evaluation. The total annual cost of hospitalization and the median annual cost per patient were estimated. Valuation was performed considering French official tariffs for 2013 and 2014 and expressed in 2016 euros. RESULTS: In this database, 4,095 patients with at least one hospitalisation were identified in the LH and 10,236 in the HH; the overall number of stays were 6,855 and 19,910, corresponding to 1.7 and 1.9 stays per patient, respectively. Overall, the economic annual cost of hospitalizations associated with HIV was estimated at €45 million in the LH, with a median cost per patient of €5,271 (€113 million in the HH, median cost of €5,226 per patient). 49.8% of hospitalised HIV patients in LH (33.4%, HH) had at least one opportunistic infection, representing 68.9% of the total annual cost (55.9%, HH). CONCLUSIONS: Hospital annual related costs associated with HIV represent at least €45 million. Hospitalizations with opportunistic infections represent half this cost and could be reduced by improving the HIV care patients cascade: earlier HIV diagnosis, earlier linkage to care, and better retention in care to avoid opportunistic occurrences.