Kaposi sarcoma (KS) is a fulminate and disseminated form of acquired immunodeficiency syndrome (AIDS)-defining neoplasm, usually presenting pulmonary involvement. We report a 40-year-old woman with AIDS and biopsy-proven KS showing unusual high-resolution computed tomography (HRCT) findings. HRCT showed areas of ground-glass attenuation with superimposed septal thickening ("crazy-paving" pattern). CT-pathologic correlation revealed that crazy-paving pattern in this case was due to accompanying pulmonary edema and hemorrhage in addition to tumor cell infiltration into the peribronchovascular interstitium, interlobular and alveolar septa. The authors suggest the inclusion of KS in the differential diagnosis of lung diseases in patients with AIDS presenting with crazy-paving pattern on the HRCT.