Surgical problems in the patient with HIV and AIDS are becoming more commonplace as the incidence of HIV seropositivity increases and patients with AIDS are living longer. Laparoscopic surgery is being applied more frequently in the diagnosis and therapy of these patients' problems as more surgeons become familiar with the techniques. Although no prospectively randomized trials exist, the benefits of the laparoscopic approach clearly have had an impact on the morbidity associated with surgery. The decreased perioperative immune depression may benefit these patients, and risks to the operative teams probably are lessened if basic tenets of laparoscopic surgery are observed.