Systematic autopsy studies of 100 patients with AIDS confirmed a high incidence of adrenal lesions. Eighty eight cases were analysed, 79 men and 9 women; 57 had opportunist infection alone, 6 had Kaposi sarcomas and 30 had an association of both pathologies. The adrenal glands were normal in 19 cases and abnormal in 64 cases. One case has non-specific spongiocytic depletion and 4 were uninterpretable because of necrosis. The main adrenocortical changes were inflammatory (N = 37) or necrotic (N = 22). The commonest sites were in the adrenal medulla in the cortex or at the cortico-medullary junction. There was a high incidence of cytomegalic inclusion bodies (44 cases). In 7 cases specific lesions were observed; cryptococcus (1), toxoplasmosis (1), tuberculosis (2), Kaposi (3). Adrenal insufficiency was diagnosed before death in only 3 cases.