Introduction: Cervicofacial cellulitis is a life-threatening infectious emergency, most often of odontogenic origin. In immunocompromised patients, especially those living with HIV, clinical presentations may be atypical and disease progression more severe. Case presentation: We report two HIV-positive patients with severe cervicofacial cellulitis. Both presented with extensive involvement of deep cervical spaces. One case was complicated by mediastinitis and septic shock. Both patients were managed with broad-spectrum intravenous antibiotics and surgical drainage. HIV infection was diagnosed during the course of hospitalization in both cases. Multidisciplinary management led to favorable outcomes. Conclusion: These cases illustrate the need for early recognition, tailored management, and multidisciplinary collaboration in HIV-positive patients presenting with cervicofacial cellulitis.