AIDS-related Kaposi sarcoma (KS) is a vascular malignancy that usually presents with mucocutaneous lesions. Bronchopulmonary involvement as an initial manifestation is a rare phenomenon. This case describes a young male presenting with pulmonary symptoms mimicking HIV-related opportunistic infection who was eventually diagnosed with primary pulmonary KS. The aim of this report is to emphasize that KS should be recognized as a differential diagnosis in AIDS patients presenting with pulmonary symptoms. Making the diagnosis may be a difficult task, at times, requiring invasive procedures such as lung biopsy.