Aims: Human Immunodeficiency Virus (HIV) and Malaria are the two main global public health threats that dent development in low and middle-income countries. This study evaluated the immunological marker and HIV/Malaria co-infection among individuals infected with HIV-1 in old Cross River State, Nigeria. Study Design: Cross-sectional study. Place and Duration of Study: University of Calabar Teaching Hospital (UCTH) and University of Uyo Teaching Hospital (UUTH) between March 2018 and August 2019. Methods: A total of 417 individuals infected with HIV-1 partook in this study. The age of these individuals ranged from 4-72 years (average age = 39.1 years). Plasma samples were analyzed for HIV and Malaria using Enzyme-Linked immunosorbent Assay. The CD4 count was enumerated using the Partec CyFlow® Counter. Plasma viral loads (PVL) were determined using the Abbott Real-Time HIV-1 assay. Results: Results showed that 230(55.1%) of the participants were in the 31-45 years age range. The majority (67.4%) of the HIV-1 infected individuals were females. An overall prevalence of HIV/Malaria coinfection in Old Cross River State, Nigeria was 14.3%, of which Uyo was 6.3% and Calabar was 3.0%. A higher prevalence of HIV/Malaria coinfection was observed among age groups <25 years (17.5%), males (5.1%), singles or divorced/widow/widower (7.7%), those with primary education (7.5%), and students (10.0%). Higher HIV/Malaria coinfection was also observed among those with CD4 cell count <200 cells/μl and 350-499 cells/μl (5.7%) and PVL >5000 copies/mL (7.9%) compared to others with 2.0% prevalence. Of all variables evaluated only marital status (p= 0.033), educational background (p= 0.000) and occupations (p =0.000) were significantly associated. Conclusions: This study further confirmed the presence of HIV/Malaria coinfection in old Cross River State, Nigeria. This study has added to the voices on the ground to give a better view on the frequency and the pattern of distribution of HIV/Malaria coinfection since limited studies have been done on this in old Cross River State, Nigeria. This, therefore, highlights the need for a well-structured approach to the management of HIV/Malaria coinfection in Nigeria.