Ramsay-Hunt syndrome (RHS) is caused by varicella zoster virus (VZV) infection in the geniculate ganglion of the facial nerve. It is characterized by facial palsy, otic pain, herpetic vesicles around the auricle and external auditory canal. We report here rare case of a RHS affecting a middle-aged individual, in human immunodeficiency virus (HIV) positive patient. The patient presented with severe herpes zoster infection of the maxillary and mandibular divisions of the trigeminal nerve. Unilateral vesicles involved lower and middle 1/3rd of trigeminal nerve distributed area on the left side of the face. Intraoral involvement included buccal, labial and palatal mucosae of the affected side. Patient also suffered with lower motor neuron facial palsy of facial muscles on the affected side.