A man in the Netherlands who started HIV treatment very early has maintained viral suppression for 23 years after stopping antiretroviral therapy. The man, then age 49, was diagnosed with acute HIV infection in 1998. He had a high viral load at diagnosis and does not have the rare CCR5-delta-32 mutation, so he is not a natural elite controller. He started treatment two weeks after diagnosis using an intensive five-drug regimen and achieved viral suppression in seven months. The man decided to discontinue his antiretrovirals after two years but agreed to join a research study. For more than two decades, he maintained an undetectable plasma viral load according to standard tests and has shown no clinical signs of HIV disease. However, HIV RNA was detectable at very low levels (under 5 copies) using ultrasensitive tests, and he has detectable HIV DNA in CD4 cells. He continues to exhibit CD8 T-cell responses, especially against HIV’s gag protein. While the man’s HIV has not been eradicated, such cases of long-term remission provide clues in the search for a functional cure.