Cardiovascular opportunistic infections are fairly encountered in patients with HIV disease. The search on this topic was carried out electronically via peer-reviewed articles in PubMed sources, Cochrane reviews and other medically-oriented search engines. Most opportunistic infections occur when the CD4 counts fall below 200/mL. The spectrum of presentations in-cludes pericarditis, pericardial effusion, myocarditis, dilated cardiomyopathy, endocarditis, pulmonary arterial hypertension and aneurysmal disease. The incidence of these complica-tions showed significant difference between the periods prior and after the introduction of the highly active antiretroviral therapy (HAART). In addition, some complications are pe-culiar to certain region of the world notably tuberculous pericarditis in areas of endemic tu-berculosis. The management of these conditions requires meticulous diagnosis, supportive therapies, prompt detection and treatment of opportunistic infections. Furthermore, the early institution of highly active antiretroviral therapy had altered the course of most of the HIV-related cardiac complications. The physicians managing these patients should also be aware of complications of treatment and potential drug-drug interactions.