IRIS is characterized by a paradoxical deterioration of clinical status after initiation of Anti-Retroviral Therapy (ART), despite improved immune function. It is caused by inflammatory response against the infectious antigen [1]. IRIS typically occurs in patients with a low initial CD4 (usually <50) and a rapid decline in viral load [2]. It is seen within a broad spectrum of HIV-related opportunistic infectious diseases and autoimmune disorders in patients who had been given Highly Active Anti-Retroviral Therapy (HAART) [3]. Our objective is to describe an HIV positive patient with Holmes´ tremor worsened by IRIS, with marked recovery after therapy with steroids.