Despite the major impact of highly active antiretroviral therapy on reducing AIDS-related complications, gastrointestinal disorders will remain a challenge for endoscopists. The endoscopic appearance of these esophageal disorders is well described. When coupled with experienced histopathologic support and clinical follow-up, endoscopy with biopsy will yield the diagnosis in essentially all cases. The efficacy of therapy underscores the importance of a prompt and accurate diagnosis. Endoscopists will remain essential for the diagnosis of esophageal disorders in AIDS. Copyright 2002, Elsevier Science (USA). All rights reserved.