Patients infected with the human immunodeficiency virus (HIV) have an increased frequency of invasive aspergillosis. We report two cases of invasive pulmonary aspergillosis in patients infected with HIV. Patients had less than 10 CD4 (helper cell) cells/mm3 (2/2), presented with fever (2/2), dyspnea (1/2), and abnormal chest radiograph (2/2). Diagnosis was established by transbronchial biopsy (1/2) and autopsy (1/2). Patients died in spite of treatment with intravenous deoxycholate amphotericin B. Prognosis of invasive pulmonary aspergillosis among patients infected with HIV remains dismal, even with aggressive antifungal treatment.