Pulmonary disease is a major source of morbidity and mortality in human immunodeficiency virus (HIV)-infected people. Over two thirds of patients infected with HIV have at least one respiratory episode during the course of their disease. Pulmonary complications in HIV can be both infectious and noninfectious. However, nearly 98% of pulmonary complications are due to respiratory infections and it has been reported that respiratory infections in HIV patients are more common at all CD4 cell strata when compared with HIV-uninfected controls. Tuberculosis is the most common infection seen in HIV-infected patients in India. Over the next decade, as more patients have access to antiretroviral therapy (ART) and chemoprophylaxis, the pulmonary manifestations of HIV will continue to evolve. Though with the widespread availability of free of cost ART under the National ART Program, there has been a significant decline in the incidence of respiratory infections, nevertheless the impact of neoplastic processes such as lymphoma and bronchogenic carcinoma on HIV morbidity and mortality remains to be defined.