**Abstract**

Advances in human immunodeficiency virus (HIV) therapy with highly active antiretroviral agents has increased the longevity of patients afflicted with this disease. HIV vasculopathy is a unique disease entity presenting as aneurysms, dissections and vascular occlusion amongst others due to HIV related vasculitis. A few studies have investigated the pathogenesis of HIV related vasculopathy. This chapter provides a brief overview of aortic aneurysms in general. Further, the current understanding of the pathogenic mechanisms underlying HIV vasculopathy with an emphasis on inflammatory mediators, histology, clinical presentation and imaging are discussed. Finally, a summary regarding management of HIV associated large vessel disease is presented.

**Keywords:** HIV, vasculopathy, aneurysms
