Esophageal disease is a common complication in patients infected with human immunodeficiency virus type-1 (HIV-1). Dysphagia, odynophagia and retrosternal pain are the most common symptons associated with the esophageal compromise. Esophageal candidiasis, the most frequent opportunistic infection, may occur in patients with long-standing infection or may be a manifestation of the seroconversion. Cytomegalovirus and Herpes simplex virus are more likely to produce esophageal ulcers or erosions. HIV itself may be responsible for ulcerative esophagitis. Neoplasms as Kaposi's sarcoma, are an infrequent cause of symptomatic disease. Barium esophagography and specially upper endoscopy are the most commonly employed diagnostic modalities for the evaluation of symptomatic patients. Endoscopy may be warranted to make a rapid diagnosis such that specific therapy will not be delayed. The use of a combination of histologic, cytologic, mycologic and virologic studies is necessary to provide an etiologic diagnosis of these lesions.