Background: The incidence of opportunistic infections and AIDS defining cancers has reduced after the introduction of combined antiretroviral therapy (cART) in patients infected by human immunodeficiency virus (HIV). However, Hodgkin Lymphoma (HL) remains one of the most common non–AIDS-defining malignancies in these patients, presenting higher risk of developing it than the general population. Classically, HIV-associated HL (HIV-HL) presents with clinical features more aggressive characteristics than in those HIV-negative individuals. Objective: This meta-analysis aimed to evaluate the clinical features in HIV-HL patients under the cART era. Methods: The study adhered to the Cochrane Handbook and 2020 PRISMA guidelines. The systematic review protocol was prospectively registered with PROSPERO (CRD42021289520). Manuscripts published until July 2023 were systematically searched in the PubMed, EMBASE, Cochrane Library, and Web of Science databases, without language and year of publication restriction. Meta-analysis was performed with dichotomous data pooled to estimate the proportion of each outcome using a random-effect effect. Quality assessment was performed by using New-Castle Ottawa scale. Certainty of evidence was graded using the GRADE. Results: Sixteen cohorts enrolling a total of 3.882 HIV-HL patients, were included in this review. Our findings indicate that HIV-HL patients were associated with a significantly improved 2-year overall survival (92%) compared to the overall proportion of survivors over a 5-year period with a high certainty of evidence according to GRADE. The 5-year progression-free survival declined to 79% and complete remission rate increased to 81%. Our meta-analysis indicates an increase for B symptoms (80%, 95% CI 0.75, 0.84) and extranodal involvement in bone marrow (43%, 95% CI 0.30, 0.47) in HIV-HL patients. Conclusions: Therefore, our systematic review and meta-analysis suggests that cART is associated with improved short-term survival of HIV-HL patients. However, some factors affect progression-free survival over a longer period compared to the 2-year overall survival rate.