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BACKGROUND As people living with human immunodeficiency virus (HIV) (PLWH) enjoy longer life expectancy with highly effective antiretroviral therapy, they are encountering challenging cardiovascular health risks. AIM To retrospectively examine the increasing burden of cardiovascular diseases in PLWH over the past decade. METHODS All hospitalizations for heart failure (HF), ischemic heart disease (IHD), and cerebrovascular disease (CeVD) in PLWH were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and ICD-10-CM codes in the National Inpatient Sample from 2008 to 2018. Outcomes included number of hospitalizations, in-hospital mortality, length of stay, and total hospital charge. Trend of the outcomes from 2008 to 2018 were analyzed using Cochran-Armitage trend test and simple linear regression. RESULTS The number of hospitalizations for HF in PLWH increased from 4212 in 2008 to 6700 in 2018 ( P trend < 0.01). Similar increasing trend was seen with those for IHD and CeVD over the decade ( P trend < 0.01). A decreasing trend of in-hospital mortality was observed in all hospitalizations of PLWH ( P trend < 0.01) and CeVD in PLWH ( P trend < 0.01), but not in those for HF ( P trend = 0.67) and IHD ( P trend = 0.13). The trend of length of stay was decreasing in all hospitalizations of PLWH ( P trend < 0.01), but increasing in those for HF in PLWH ( P trend < 0.01). An increasing trend of total hospital charge was observed in hospitalizations for HF, IHD, and CeVD ( P trend < 0.01). CONCLUSION The burden of cardiovascular diseases has significantly increased in hospitalizations of PLWH from 2008 to 2018. Continued efforts are needed to address the additional cardiovascular risks in this vulnerable population.