Molluscum contagiosum is known to occur in the advanced stages of immunodeficiency in HIV infected patients and may present as atypical variants including giant molluscum. Here we describe the rare occurrence of giant molluscum contagiosum in an HIV seropositive child, which warranted surgical excision followed by skin grafting due to its unusually large size. We also highlight in this case report, a rare granulomatous inflammatory reaction pattern to molluscum with panniculitis.