Frequency, clinical features, and prognosis of pulmonary aspergillosis were studied in AIDS patients. This retrospective study was carried out between 1987 and 1995, among 420 AIDS patients. Aspergillus sp. was isolated in 12 patients. Invasive aspergillosis is an uncommon infectious complication in patients with AIDS. Aspergillus sp. was isolated in only 12 of the 420 patients with AIDS followed between 1987 and 1995 in our department. Invasive aspergillosis was confirmed by histology in eight patients. Invasive aspergillosis was considered as probable with the halo sign in chest CT scan and two positive bronchoalveolar lavage fluid cultures for Aspergillus sp. in one patient. In the three other cases, Aspergillus sp. isolation was considered as colonization. Cough and fever were the most common symptoms. Radiological patterns included upper-lobe cavitary disease, nodules, pleura-based lesions, and diffuse infiltrates (mainly of the lower lobe). Typical CT scan findings were: pleura-based lesions, triangular shaped lesions contiguous to the pleura of the major fissure, and the halo sign. A new and sensitive Elisa test could be used to detect significant amounts of Aspergillus sp. antigens (galactomannan) in body fluids and may provide a non-invasive diagnosis test. Death was the usual outcome, despite treatment with amphotericin B and/or itraconazole. New approaches must be investigated.Il s'agit d'une etude retrospective sur la periode 1987-1995 concernant 420 patients presentant un sida declare, dont 12 patients porteurs d'Aspergillus sp. Parmi les 420 patients sideens suivis dans notre etude de 1987 a 1995, Aspergillus sp. n'a ete isole que chez 12. Pour huit patients, le diagnostic d'aspergillose pulmonaire invasive etait certain (prelevement autopsique : examen histologique et culture positifs). Le diagnostic a ete considere comme probable dans un cas ou Aspergillus sp. a ete isole dans 2 LBA et ou le patient presentait un signe du halo au scanner. Pour les trois autres patients, l'identification d'Aspergillus sp. etait consideree comme une simple colonisation. La toux et la fievre dans un contexte de degradation de l'etat general etaient les signes cliniques les plus frequemment retrouves. La radiographie permettait d'objectiver des formes localisees (infiltrats arrondis ou triangulaires, nodules isoles ou multiples) et des formes diffuses (infiltrats alveolaires plus ou moins excaves, aspects multinodulaires, epanchements pleuraux). Le scanner a recherche un signe evocateur : le signe du halo. Un nouveau test Elisa detectant les antigenes aspergillaires (galactomannane) avec une bonne sensibilite et specificite pourrait etre utile au diagnostic precoce. Le deces reste l'issue la plus frequente malgre la mise en place d'un traitement par l'amphotericine B (antifongique de reference) et/ou l'itraconazole. De nouvelles molecules et l'institution plus precoce d'un traitement donneront peut-etre de meilleurs resultats.