Highly active antiretroviral therapy (HAART) has changed the most common cause of death among patients infected with the human immunodeficiency virus (HIV). These patients are known to be at increased risk for lung cancer compared with the general population. Recently, HIV-infected patients who need surgical treatment of lung cancers are becoming increasingly common. We present a 60-year-old HIV-infected man with locally advanced lung cancer with a helper T-lymphocyte count of 195 cells/μl at the time of lung cancer diagnosis. HAART was initiated before surgery, and extended resection was performed without discontinuance of HAART. The patient successfully recovered from surgery without complication.