A review of patients proven to have the acquired immunodeficiency syndrome (AIDS) at autopsy revealed that 15.0% had one or more surgical procedures performed while they were infected with the immunodeficiency virus (HIV). Complications of AIDS were not frequently amenable to surgical therapy. Only 3.7% had an operation for a condition specifically related to AIDS, with mean postoperative survival of 79 days. Eleven patients (2.5%) required surgical treatment for conditions unrelated to HIV infection. Minor therapeutic and diagnostic surgical procedures were performed in 8.8% of patients hospitalized with AIDS. Postoperative survival was longer in patients with HIV infection than with clinical AIDS. No seroconversions to HIV positivity occurred in any personnel performing the procedures. Risk of accidental infection to operating room personnel via blood contact during surgical procedures is not excessive and can be reduced by adherence to universal precautions.