With the growing number of patients with the acquired immunodeficiency syndrome there has been a marked increase in the incidence of Kaposi's sarcoma. Kaposi's sarcoma of the penis was the initial presenting manifestation of acquired immunodeficiency syndrome in 4 patients. Overall, less than 3% of all acquired immunodeficiency syndrome patients with Kaposi's sarcoma have the initial lesion on the penis. However, eventually almost 20% of those with Kaposi's sarcoma will have lesions on the genitalia. Therefore, urologists must have an understanding of the entity and its management. A conservative approach to treatment of these lesions is recommended.