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Introduction Otorhinolaryngologic manifestations account for almost 80% of the various manifestations of Human Immunodeficiency Virus (HIV) infection, of which Human Papilloma Virus (HPV) associated laryngeal papilloma and laryngeal malignancy are the most common pertaining to larynx. Case Report A 55year old male patient on Antiretroviral treatment since 10 years who was a chronic smoker, presented with difficulty in breathing and hoarseness of voice. Flexible laryngoscopy revealed a white, horny, wide based keratotic lesion completely covering rima glottidis resulting in obstruction of airway and stridor. Tracheostomy was done followed by        endoscopic excision of the lesion. Histopathologic examination showed features of hyperkeratotic papilloma and lesion was tested negative for HPV. Discussion We report this case to emphasize on the differential diagnosis of laryngeal papillomatous lesion. A hyperkeratotic papilloma, with a dual aetiology of retroviral disease  and smoking, presenting with stridor, the lesion being negative for HPV infection makes it uncommon from other laryngeal lesions.