Transplantation of HIV-infected patients is complicated by practical as well as ethical considerations. However, advances in the treatment of HIV-infected patients that have resulted in improved survival may also improve outcome following transplantation. Recent reports indicate potential detrimental effects of specific immunosuppressive agents in the HIV-infected transplant patient, as well as potential positive effects of others. Similarly, new information about the activity of certain antiretroviral agents suggests that they may be optimal for first-line management of HIV infection in this setting. Careful monitoring of patients treated with these agents plus other drugs commonly used in the transplant setting, as well as carefully conducted prospective trials, will be necessary to ultimately determine optimal treatment protocols.