Human immunodeficiency virus (HIV) infection is a global public health issue that is frequently associated with cardiovascular involvement. Left ventricular dysfunction, an independent predictor of mortality in HIV-infected patients, is the result of many causes in this population and may result in dilated cardiomyopathy and congestive heart failure in about 10% of patients. Antiinfective and highly active antiretroviral therapies may be particularly helpful in this population to reduce HIV-associated diseases. However, some of these drugs exhibit mitochondrial toxicity being expected to impair myocardial function. The HIV-associated cardiomyopathy is often clinically occult or attributed incorrectly to other noncardiac disease processes. Therefore, a heightened awareness and routine screening for cardiovascular involvement in HIV-infected patients would lead to earlier detection and the hope for a reduction in associated morbidity and mortality. In summary, cardiovascular complications, particular HIV-associated cardiomyopathy, are important contributors to morbidity and mortality in HIV-infected patients that can be detected early in many cases and may be treated effectively. The therapy of HIV-associated cardiomyopathy comprises standard medical treatment for heart failure.