Human immunodeficiency virus (HIV) infection and antiretroviral medications are independent risk factors for cardiovascular disease. In the pre–antiretroviral therapy (ART) era, HIV-infected patients had increased morbidity and mortality from opportunistic infections; in the post-ART era, these patients are at increased risk of chronic diseases such as acute coronary syndrome, coronary artery disease, cardiac arrhythmias, and cardiomyopathy. They may present with vague symptoms such as weakness, dyspnea, or fatigue as the initial presentation of their cardiovascular disease. An overview of the clinical presentation, workup, management, and treatment of different cardiovascular disease is provided in this article.