Care of HIV-infected patients with gastrointestinal involvement represents a growing clinical challenge. Differential diagnosis and investigations should be guided by the degree of immunosuppression indicated by the CD4 lymphocyte count. As curative therapies for most of the GI problems are not available, therapy is usually directed at symptom relief with the goal to improve the quality of life. Functional status and psychosocial issues need to be considered for the successful management of these patients.