In the developed world, a significant increase in the incidence of protozoan diarrhoea was observed following the AIDS epidemic. The profound immunodeficiency associated with advanced HIV disease produced increased susceptibility to opportunistic protozoan infections. The resultant profuse diarrhoea, malabsorption and weight loss contributed to the high morbidity and mortality rates associated with the epidemic. The success of highly active antiretroviral therapy (HAART) in suppressing viral replication has led to a reduced incidence of AIDS-related opportunistic infections and this has contributed to decreased morbidity and mortality. In this review, we examine current management practices for HIV-related opportunistic protozoan diarrhoea