With the recent advances in treatment of AIDS, we have seen an increase in detection of malignant neoplasms in our patients. While some malignancies have an undoubted relationship with the HIV infection, others represent nothing more than sporadic reports and their relationship with the underlying immunological deficit is all but clear. We report the imaging findings in three patients with AIDS and an adrenal adenocarcinoma. We also discuss the peculiar imaging aspects of these pathological entities and report some pathogenetic theories on the relationship between AIDS and neoplasms.