Cryptococcal disease is an opportunistic infection that occurs primarily among people with advanced HIV disease and is an important cause of morbidity and mortality in this group. By far the most common presentation of cryptococcal disease is cryptococcal meningitis, which accounts for an estimated 15% of all AIDS-related deaths globally, three quarters of which are in sub-Saharan Africa. These guidelines provide recommendations and good practice guidance on the optimal approach to diagnosing cryptococcal meningitis, strategies for preventing invasive cryptococcal disease through cryptococcal antigen screening and pre-emptive fluconazole therapy, treating cryptococcal meningitis with combination antifungal therapy regimens, preventing, monitoring and managing amphotericin B drug toxicity, recommendations against adjunctive therapy with systemic corticosteroids and recommendations on the timing of antiretroviral therapy (ART) initiation.