The risk of human immunodeficiency virus (HIV) transmission after a hollow needlestick injury contaminated with HIV-infected blood is 0.4%. The HIV seroprevalence of patients in many urban hospitals is significant, and surgeons are frequently exposed to patients' blood in the course of their work. HIV infection is an occupational disease. Strict barrier precautions significantly reduce but do not eliminate the risk of exposure to patients' blood, and routine HIV testing of surgical patients remains controversial. The risk of HIV transmission from a health care worker to a patient during an invasive procedure is unknown; routine HIV testing of health care workers is under discussion. State Workers' Compensation is inadequate to provide supplemental income to resident physicians with occupationally acquired HIV infection who are unable to work. Both HIV-positive and HIV-negative patients deserve the highest quality of surgical care.